Individual
MR. KALEB L. JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-3024
(309) 655-3739
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-3024
(309) 655-3739
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036142613
IL
207V00000X
Obstetrics & Gynecology Physician
125.063154
IL
207V00000X
Obstetrics & Gynecology Physician
R-34-2015
NM
Other
Enumeration date
07/05/2013
Last updated
09/06/2024
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