Individual
JACOB BRAD RABE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-6710
Mailing address
504 W MELBOURNE AVE, PEORIA, IL 61604-2844
(801) 458-8549
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
125.059410
IL
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
MD60455396
WA
Other
Enumeration date
06/07/2011
Last updated
10/25/2019
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