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NPI Code Detail

MEDICARE: CELESTE ELIZABETH JONES L.AC

MEDICARE:   CELESTE ELIZABETH JONES  L.AC
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
1171100000XAcupuncturist198001230IL

General Provider Information

NPI Number : 1194267856
Entity Type Code : Individual
Provider Name (Legal Business Name) : CELESTE ELIZABETH JONES L.AC
Provider Business Mailing Address
First Line : 3234 W FULLERTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-2594
Country : US
Telephone Number : 773-466-9882
Fax Number :
Provider Business Practice Location Address
First Line : 3234 W FULLERTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-2594
Country : US
Telephone Number : 773-466-9882
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2016
Last Update Date : 11/12/2016

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Directions to “ CELESTE ELIZABETH JONES L.AC” Practice Location

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