Individual
MRS. MALLORY JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2430 ESPLANADE DR STE B, ALGONQUIN, IL 60102-5500
(847) 458-7546
(224) 333-3436
Mailing address
2430 ESPLANADE DR STE B, ALGONQUIN, IL 60102-5500
(847) 458-7546
(224) 333-3436
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.006519
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085.006519
IL LICENSE
IL
Enumeration date
03/05/2018
Last updated
03/05/2018
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