Provider Demographics
NPI:1437536695
Name:COX, JASON (LAC)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:
Last Name:COX
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1525 N ARLINGTON HEIGHTS RD APT A
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-3968
Mailing Address - Country:US
Mailing Address - Phone:847-262-7796
Mailing Address - Fax:
Practice Address - Street 1:496 CRESCENT BLVD
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-4540
Practice Address - Country:US
Practice Address - Phone:847-262-7796
Practice Address - Fax:847-637-5277
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-27
Last Update Date:2024-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.001238171100000X
NC957171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist