Provider Demographics
NPI:1396527347
Name:JONES, COPRICE (HOME CARE PROVIDER)
Entity type:Individual
Prefix:
First Name:COPRICE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:HOME CARE PROVIDER
Other - Prefix:
Other - First Name:COPRICE
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DEATH DOULA
Mailing Address - Street 1:1755 E 55TH ST APT 803
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-5991
Mailing Address - Country:US
Mailing Address - Phone:773-850-7335
Mailing Address - Fax:
Practice Address - Street 1:1755 E 55TH ST APT 803
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-5991
Practice Address - Country:US
Practice Address - Phone:773-850-7335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3002494376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide