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Individual

ABRAHAM JACOB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
5320 159TH ST STE 300, OAK FOREST, IL 60452-3333
(708) 687-4747
(708) 687-4749
Mailing address
5320 159TH ST STE 300, OAK FOREST, IL 60452-3333
(708) 687-4747
(708) 687-4749

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1515389
CIGNA
IL
01
1618642
BC/ BS
IL
01
7602301
AETNA
IL
Enumeration date
09/26/2007
Last updated
09/26/2007
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