Individual
KATRINA JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8138 S VERNON AVE, CHICAGO, IL 60619-4914
(773) 882-3235
Mailing address
111 N WABASH AVE STE 100, CHICAGO, IL 60602-1903
(773) 882-3235
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
149011408
IL
Other
Enumeration date
02/20/2023
Last updated
02/20/2023
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