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Individual

MRS. CORINE JONES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2853 141ST PL, BLUE ISLAND, IL 60406-3311
Mailing address
5000 S 5TH AVE, HINES, IL 60141-3030

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
043066005
IL
3747A0650X
Attendant Care Provider
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
$$$$$$$$$
IL
05
3747A0650X
IL
Enumeration date
10/03/2019
Last updated
10/04/2019
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