Individual
STEPHEN KELLY JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
THE JOHNS HOPKINS HOSPITAL, 600 NORTH WOLFE STREET, BALTIMORE, MD 21287-0001
(410) 955-5000
Mailing address
1 WESTBROOK CORPORATE CTR, STE 240, WESTCHESTER, IL 60154-5745
(708) 236-2673
Taxonomy
Speciality
Code
Description
License number
State
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
336106572
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/09/2012
Last updated
07/13/2018
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