Provider Demographics
NPI:1992077440
Name:COX JONES, DINA
Entity type:Individual
Prefix:
First Name:DINA
Middle Name:
Last Name:COX JONES
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 1:10637 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60628-2640
Mailing Address - Country:US
Mailing Address - Phone:773-751-9556
Mailing Address - Fax:773-264-8343
Practice Address - Street 1:10637 S STATE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60628-2640
Practice Address - Country:US
Practice Address - Phone:773-751-9556
Practice Address - Fax:773-264-8343
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL472400222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist