Individual
JACOB ODEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
731 S PLYMOUTH CT, CHICAGO, IL 60605-2097
(580) 481-0386
Mailing address
731 S PLYMOUTH CT APT 608, CHICAGO, IL 60605-2236
(580) 481-0386
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
IL
Other
Enumeration date
02/28/2025
Last updated
02/28/2025
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