Provider Demographics
NPI:1477898153
Name:ALT, JOCELYN (CD)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:ALT
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 CHICAGO AVE
Mailing Address - Street 2:UNIT 618
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-6009
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1735 CHICAGO AVE
Practice Address - Street 2:UNIT 618
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-6009
Practice Address - Country:US
Practice Address - Phone:872-222-9234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula