Provider Demographics
NPI:1598779233
Name:JONES, FORREST (MD)
Entity Type:Individual
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First Name:FORREST
Middle Name:
Last Name:JONES
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2231 E. 95TH STREET
Mailing Address - Street 2:JENCARE NEIGHBORHOOD MEDICAL CENTER SOUTH CHICAGO, LLC
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617
Mailing Address - Country:US
Mailing Address - Phone:773-768-7700
Mailing Address - Fax:773-768-7768
Practice Address - Street 1:2231 E. 95TH STREET
Practice Address - Street 2:JENCARE NEIGHBORHOOD MEDICAL CENTER SOUTH CHICAGO, LLC
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-3913
Practice Address - Country:US
Practice Address - Phone:773-768-7700
Practice Address - Fax:773-768-7768
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2016-01-25
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Provider Licenses
StateLicense IDTaxonomies
IL036-055799207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD14069Medicare UPIN