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Individual

DR. JACOB W GREENSPAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
350 OAK KNOLL TER, NORTHBROOK, IL 60062-1048
(847) 562-9864
(847) 562-9865
Mailing address
PO BOX 220, MATTESON, IL 60443-0220
(708) 747-5850
(708) 747-9991

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016003364
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
016003364
IL
Enumeration date
07/28/2005
Last updated
11/25/2009
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