John Jacobsen
Psychiatry & Neurology, Neurology in Oak Park, IL. Individual provider (NPI-1).
NPI number1477548477
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1477548477
- Entity type
- Individual (NPI-1)
- Name
- John Jacobsen
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 15, 2005
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology, Neurology | 036-063370 | IL | Yes |
Practice location
1 Erie CtSuite 7020
Oak Park, IL 60302-2566
Phone 630-789-2550
Mailing address
777 Oakmont LnSuite 1600
Westmont, IL 60559-5511
Phone 630-288-6215 · Fax 630-214-9344
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