Provider Demographics
NPI:1164979399
Name:JONES, MILENA
Entity Type:Individual
Prefix:
First Name:MILENA
Middle Name:
Last Name:JONES
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 1:408 LAUREL LN
Mailing Address - Street 2:
Mailing Address - City:DEKALB
Mailing Address - State:IL
Mailing Address - Zip Code:60115-1767
Mailing Address - Country:US
Mailing Address - Phone:847-476-6777
Mailing Address - Fax:
Practice Address - Street 1:1315 N HIGHLAND AVE STE 203
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-1460
Practice Address - Country:US
Practice Address - Phone:630-906-1800
Practice Address - Fax:630-906-9860
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209014808363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily