Provider Demographics
NPI:1093144545
Name:MENDEZ, JOCELIN NICOLE
Entity Type:Individual
Prefix:MISS
First Name:JOCELIN
Middle Name:NICOLE
Last Name:MENDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5080 W 89TH CT
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-1629
Mailing Address - Country:US
Mailing Address - Phone:219-671-7869
Mailing Address - Fax:
Practice Address - Street 1:2500 175TH ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:IL
Practice Address - Zip Code:60438-1801
Practice Address - Country:US
Practice Address - Phone:708-418-3612
Practice Address - Fax:708-418-3613
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other