Provider Demographics
NPI:1740394063
Name:JONES, MARY ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:ELIZABETH
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2160 S 1ST AVE
Mailing Address - Street 2:MAGUIRE BLD. RM 3322
Mailing Address - City:MAYWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60153-3328
Mailing Address - Country:US
Mailing Address - Phone:708-327-9133
Mailing Address - Fax:708-327-9132
Practice Address - Street 1:2160 S 1ST AVE
Practice Address - Street 2:MAGUIRE BLD. RM 3322
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153-3328
Practice Address - Country:US
Practice Address - Phone:708-327-9133
Practice Address - Fax:708-327-9132
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2021-06-24
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Provider Licenses
StateLicense IDTaxonomies
IL036101861208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH28125Medicare UPIN