Individual
CHRISTINA C JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
602 REVERE RD, GLENVIEW, IL 60025-3941
(847) 912-6425
Mailing address
602 REVERE RD, GLENVIEW, IL 60025-3941
(847) 912-6425
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.028116
IL
Other
Enumeration date
08/26/2009
Last updated
08/26/2009
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