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NPI Code Detail

MEDICARE: JONIKA P ROSS

MEDICARE: JONIKA P ROSS
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1316241839
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONIKA P ROSS
Provider Business Mailing Address
First Line : 17746 OAK PARK AVE
Second Line :
City : TINLEY PARK
State : IL
Zip : 60477-3936
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 450 W 14TH ST
Second Line :
City : CHICAGO HEIGHTS
State : IL
Zip : 60411-2463
Country : US
Telephone Number : 708-754-8815
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2010
Last Update Date : 12/23/2010

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Directions to “ JONIKA P ROSS ” Practice Location

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