Healthcare Provider Details

I. General information

NPI: 1720433048
Provider Name (Legal Business Name): MARY ANN JONES FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2016
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 W MONROE ST
CHICAGO IL
60606-4703
US

IV. Provider business mailing address

20031 JUNIPER AVE
LYNWOOD IL
60411-6838
US

V. Phone/Fax

Practice location:
  • Phone: 888-660-4425
  • Fax:
Mailing address:
  • Phone: 773-680-9832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number277002426
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number277002426
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: