Individual
JACOB JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
8301 SKOKIE BLVD, SKOKIE, IL 60077-2546
(847) 674-0455
(847) 674-0466
Mailing address
890 E ZINNIA LN, PALATINE, IL 60074-1260
(847) 284-2198
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.004689
IL
Other
Enumeration date
12/02/2018
Last updated
04/17/2020
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