Organization
DR BRIAN JACOBY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN JACOBY DC (OWNER)
18473387590
Entity
Organization
Contact information
Practice address
1360 N SANDBURG TERRACE, CHICAGO, IL 60610-2050
(312) 944-4653
(773) 337-9106
Mailing address
1735 N PAULINA ST, # 301, CHICAGO, IL 60622-1133
(184) 733-8759
(773) 337-9106
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038011130
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
038011130
PHYSICIAN LICENSE
IL
Enumeration date
03/27/2012
Last updated
03/27/2012
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