Individual
EMILY JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4401 S HARLEM AVE, STICKNEY, IL 60402-4250
(708) 788-3400
(708) 788-3472
Mailing address
4401 S HARLEM AVE, STICKNEY, IL 60402-4250
(708) 788-3400
(708) 788-3472
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
036152736
IL
207WX0120X
Cornea and External Diseases Specialist Physician
Primary
036152736
IL
207WX0120X
Cornea and External Diseases Specialist Physician
287768-1
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010036152736
—
IL
Enumeration date
04/04/2013
Last updated
06/01/2021
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