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NPI Code Detail

MEDICARE: MRS. ANDREA REVETHIS JONES FNP-BC

MEDICARE: MRS. ANDREA REVETHIS JONES FNP-BC
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
1363L00000XNurse Practitioner209013014IL
2363LF0000XFamily Nurse Practitioner209013014IL

General Provider Information

NPI Number : 1356727713
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANDREA REVETHIS JONES FNP-BC
Provider Business Mailing Address
First Line : 12251 S 80TH AVE
Second Line :
City : PALOS HEIGHTS
State : IL
Zip : 60463-1290
Country : US
Telephone Number : 708-923-5300
Fax Number : 708-923-5301
Provider Business Practice Location Address
First Line : 12251 S 80TH AVE
Second Line :
City : PALOS HEIGHTS
State : IL
Zip : 60463-1290
Country : US
Telephone Number : 708-923-5300
Fax Number : 708-923-5301
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2015
Last Update Date : 04/16/2026

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Directions to “ MRS. ANDREA REVETHIS JONES FNP-BC” Practice Location

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