Individual
EMILY E JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3289 N MAYFAIR RD, WAUWATOSA, WI 53222-3203
(414) 771-7900
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085007940
IL
363A00000X
Physician Assistant
Primary
5715
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100193446
—
WI
Enumeration date
03/24/2020
Last updated
02/07/2025
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