Provider Demographics
NPI:1912450529
Name:JONES, JAMILA
Entity Type:Individual
Prefix:MISS
First Name:JAMILA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:JAMILA
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC
Mailing Address - Street 1:1730 E 70TH ST
Mailing Address - Street 2:APT 3
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649-1478
Mailing Address - Country:US
Mailing Address - Phone:312-451-9230
Mailing Address - Fax:
Practice Address - Street 1:1730 E 70TH ST
Practice Address - Street 2:APT 3
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-1478
Practice Address - Country:US
Practice Address - Phone:312-451-9230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-31
Last Update Date:2016-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.010254101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional