Individual provider Active NPI

Corine Jones

  • Attendant Care Provider
  • Blue Island, IL
National Provider Identifier
1811538671
Registry record updated Oct 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Attendant Care ProviderTaxonomy code 3747A0650X
Practice address
2853 141St PL
Blue Island, IL 60406-3311
NPI assigned
Oct 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 043066005 IL
Attendant Care Provider 3747A0650X Primary

Addresses

Primary practice location

2853 141St PL
Blue Island, IL 60406-3311

Mailing address

5000 S 5TH Ave
Hines, IL 60141-3030

Other practice location 1

2853 141st Pl
Blue Island, IL 60406-3311
Phone (708) 897-6785

Other identifiers 2

IdentifierTypeStateIssuer
$$$$$$$$$MedicaidIL
3747A0650XMedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
043066005ILMDLicensed Vocational Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1811538671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 S 5TH AVE",
            "city": "HINES",
            "state": "IL",
            "postal_code": "601413030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2853 141ST PL",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604063311"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2853 141st Pl",
            "address_purpose": "LOCATION",
            "city": "Blue Island",
            "state": "IL",
            "postal_code": "604063311",
            "country_code": "US",
            "telephone_number": "708-897-6785",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "CORINE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-03",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "IL",
            "license": "043066005",
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "$$$$$$$$$",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3747A0650X",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Island, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.