Individual
MARY JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
307 GOLF MILL CTR, NILES, IL 60714-1217
(847) 803-1770
Mailing address
1945 N ROYAL BIRKDALE DR, VERNON HILLS, IL 60061-4572
(312) 320-0333
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
46008491
IL
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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