Provider Demographics
NPI:1265846604
Name:JONES, JEFFREY
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 S LASALLE ST
Mailing Address - Street 2:503
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60603
Mailing Address - Country:US
Mailing Address - Phone:312-236-9355
Mailing Address - Fax:
Practice Address - Street 1:19 S LASALLE ST
Practice Address - Street 2:503
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603
Practice Address - Country:US
Practice Address - Phone:312-236-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-012629111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor