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Organization
CHICAGO NEUROPATHOLOGY SERVICE
Active
Organization
CHICAGO NEUROPATHOLOGY SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE JACOBSOHN M.D. (PRESIDENT)
(847) 498-7512
Entity
Organization
Contact information
Practice address
5 REVERE DR, SUITE 200, NORTHBROOK, IL 60062-1566
(847) 498-7512
Mailing address
DEPT 77-9452, CHICAGO, IL 60678-9452
(847) 676-0091
(847) 676-2374
Taxonomy
Speciality
Code
Description
License number
State
207ZN0500X
Neuropathology Physician
—
IL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01623068
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/17/2006
Last updated
09/11/2025
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