Individual
DR. KENNETH E JACOBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
750 FLETCHER DR, SUITE 300, ELGIN, IL 60123-4703
(847) 741-3127
(847) 741-3173
Mailing address
750 FLETCHER DR, SUITE 300, ELGIN, IL 60123-4703
(847) 741-3127
(847) 741-3173
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04532255
BCBS
IL
01
—
5432480001
DMERC
IL
01
—
P00206050
RAILROAD MEDICARE
IL
Enumeration date
09/25/2006
Last updated
07/08/2007
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