Individual
JACOB PHILIP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
802 N 9TH ST, SPRINGFIELD, IL 62702
(847) 701-1457
(847) 496-7603
Mailing address
2050 E ALGONQUIN RD, SUITE 610, SCHAUMBURG, IL 60173-4144
(888) 988-4066
(847) 496-4850
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019029840
IL
Other
Enumeration date
06/24/2014
Last updated
07/05/2018
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