Individual
DANIEL JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1820 E BOULDER DR, MOUNT PROSPECT, IL 60056-1961
(224) 475-2433
Mailing address
1820 E BOULDER DR, MOUNT PROSPECT, IL 60056-1961
(224) 475-2433
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036097540
IL
Other
Enumeration date
03/26/2014
Last updated
03/26/2014
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