Individual
MRS. JIBI JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
3520 W NORTH AVE, STONE PARK, IL 60165-1042
(708) 356-6341
Mailing address
8112 CEDAR DR, WOODRIDGE, IL 60517-4646
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209024796
IL
Other
Enumeration date
02/15/2022
Last updated
02/15/2022
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