Individual
ANGELA JONESACOSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10046 S WESTERN AVE, CHICAGO, IL 60643-1926
(708) 513-0256
Mailing address
10046 S WESTERN AVE, CHICAGO, IL 60643-1926
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
IL
Other
Enumeration date
02/28/2017
Last updated
02/28/2017
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