Provider Demographics
NPI:1316716939
Name:JONES-COOPER, JACQUES J
Entity type:Individual
Prefix:
First Name:JACQUES
Middle Name:J
Last Name:JONES-COOPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:422 W 34TH ST APT 310
Mailing Address - Street 2:
Mailing Address - City:STEGER
Mailing Address - State:IL
Mailing Address - Zip Code:60475-1443
Mailing Address - Country:US
Mailing Address - Phone:480-406-3623
Mailing Address - Fax:
Practice Address - Street 1:2112 W GALENA BLVD STE 8-316
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-3255
Practice Address - Country:US
Practice Address - Phone:630-661-7250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-22
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant