Individual
MAURA JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4732 N LINCOLN AVE STE 200, CHICAGO, IL 60625-8561
(312) 926-6000
(312) 926-6165
Mailing address
4732 N LINCOLN AVE STE 200, CHICAGO, IL 60625-8561
(312) 926-6000
(312) 926-6165
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036156947
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/30/2018
Last updated
12/08/2022
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