MEDICARE: UNYA JONES CNA

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	376K00000X	Nurse's Aide		IL

General Provider Information

NPI Number	:	1982171310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	UNYA JONES CNA

Provider Business Mailing Address
First Line	:	1617 ASTOR ST APT 2E
Second Line	:
City	:	CALUMET CITY
State	:	IL
Zip	:	60409-1587
Country	:	US
Telephone Number	:	708-527-1046
Fax Number	:

Provider Business Practice Location Address
First Line	:	1617 ASTOR ST APT 2E
Second Line	:
City	:	CALUMET CITY
State	:	IL
Zip	:	60409-1587
Country	:	US
Telephone Number	:	708-527-1046
Fax Number	:

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

Provider Enumeration Date	:	10/24/2018
Last Update Date	:	10/24/2018

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