MEDICARE: KORA M FIELDS-JONES APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1043837636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KORA M FIELDS-JONES APRN

Provider Business Mailing Address
First Line	:	131 TECUMSEH DR
Second Line	:
City	:	BOLINGBROOK
State	:	IL
Zip	:	60490-5566
Country	:	US
Telephone Number	:	773-297-9050
Fax Number	:

Provider Business Practice Location Address
First Line	:	131 TECUMSEH DR
Second Line	:
City	:	BOLINGBROOK
State	:	IL
Zip	:	60490-5566
Country	:	US
Telephone Number	:	773-297-9050
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2020
Last Update Date	:	03/15/2026

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