MEDICARE: EVA VIVIAN-JONES

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	376J00000X	Homemaker	1899264	IL

General Provider Information

NPI Number	:	1295002673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVA VIVIAN-JONES

Provider Business Mailing Address
First Line	:	8112 S RICHMOND ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60652-2735
Country	:	US
Telephone Number	:	773-970-1801
Fax Number	:	888-649-4611

Provider Business Practice Location Address
First Line	:	8112 S RICHMOND ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60652-2735
Country	:	US
Telephone Number	:	773-970-1801
Fax Number	:	888-649-4611

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

Provider Enumeration Date	:	11/29/2011
Last Update Date	:	11/29/2011

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Directions to “ EVA VIVIAN-JONES ” Practice Location

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