Individual
LAVONNE JONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11343 S ELIZABETH ST, CHICAGO, IL 60643-4429
(773) 957-5967
Mailing address
11343 S ELIZABETH ST, CHICAGO, IL 60643-4429
(773) 957-5967
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
174H00000X
IL
Other
Enumeration date
08/04/2015
Last updated
08/04/2015
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