Provider Demographics
NPI:1598861015
Name:JONES, ANN LOUISE (OD)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:LOUISE
Last Name:JONES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:L
Other - Last Name:LAURENZI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:2050 PFINGSTEN RD STE 280
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-1324
Mailing Address - Country:US
Mailing Address - Phone:847-657-5800
Mailing Address - Fax:
Practice Address - Street 1:2050 PFINGSTEN RD STE 280
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-1324
Practice Address - Country:US
Practice Address - Phone:847-657-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010039152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2182963Medicaid
OHU71498Medicare UPIN