Individual
TONIA JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
1009 S. WOOD ST, CHICAGO, IL 60612-4493
(312) 996-6771
Mailing address
1009 S WOOD ST, CHICAGO, IL 60612-3747
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
209030618
IL
363LF0000X
Family Nurse Practitioner
103325
OK
Other
Enumeration date
10/21/2015
Last updated
11/01/2024
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