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General NPI Number Information
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NPI Number | 1629873138
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Entity Type | Individual
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Provider Name | INDIA JONES
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Gender | Female
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Dates
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Enumeration Date | 02/18/2025
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Last Update Date | 05/21/2025
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Provider Practice Location Address
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Address Line | 5569 W 95TH ST
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City | OAK LAWN
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State | IL
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Zip | 60453-2356
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Country | US
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Telephone | 312-678-1822
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Fax |
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Provider Business Mailing Address
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Address Line | 18345 PIERCE AVE
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City | HOMEWOOD
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State | IL
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Zip | 60430-3450
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Country | US
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Telephone | 708-369-3629
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150.115924
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License Number State | IL
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