Provider Demographics
NPI:1326067042
Name:JONES, MARK A (DPM,)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:JONES
Suffix:
Gender:M
Credentials:DPM,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:25 E SCHAUMBURG RD STE 110
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60194-3548
Mailing Address - Country:US
Mailing Address - Phone:847-352-1473
Mailing Address - Fax:847-352-1479
Practice Address - Street 1:25 E SCHAUMBURG RD STE 110
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60194-3548
Practice Address - Country:US
Practice Address - Phone:847-352-1473
Practice Address - Fax:847-352-1479
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016-005007213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
K10423Medicare PIN
ILK53237Medicare PIN
ILU85254Medicare UPIN
IL0139440002Medicare NSC