Organization
LIBERTYVILLE ANKLE & FOOT CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT A JACOBSEN DPM (OWNER)
(847) 362-1320
Entity
Organization
Contact information
Practice address
1017 W PARK AVE, SUITE A, LIBERTYVILLE, IL 60048-2502
(847) 362-1320
(847) 362-1823
Mailing address
1017 W PARK AVE, SUITE A, LIBERTYVILLE, IL 60048-2502
(847) 362-1320
(847) 362-1823
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016-005031
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016005031
—
IL
01
—
04932511
BLUECROSS
IL
01
—
P00347050
RAILROAD MEDICARE
IL
Enumeration date
12/21/2005
Last updated
07/25/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us