Organization
ELLEN JACOBSEN, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELLEN JACOBSEN M.D. (OWNER)
(217) 367-7546
Entity
Organization
Contact information
Practice address
407 W SPRINGFIELD AVE, URBANA, IL 61801-8809
(217) 367-7546
(217) 367-2240
Mailing address
407 W SPRINGFIELD AVE, URBANA, IL 61801-8809
(217) 367-7546
(217) 367-2240
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
05/14/2008
Last updated
05/14/2008
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