Basic Information
Provider Information
NPI: 1215908900
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JONES
FirstName: CYNTHIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6400 SHAFER CT STE 700
Address2:  
City: ROSEMONT
State: IL
PostalCode: 600184989
CountryCode: US
TelephoneNumber: 3463761702
FaxNumber: 2245322780
Practice Location
Address1: 220 CONTINENTAL DR STE 407
Address2:  
City: NEWARK
State: DE
PostalCode: 197134315
CountryCode: US
TelephoneNumber: 3025333800
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/30/2006
LastUpdateDate: 09/22/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/22/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XLD0000106DEY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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