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General NPI Number Information
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NPI Number | 1669715959
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Entity Type | Individual
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Provider Name | EMILY JACOBS MD
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Gender | Female
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Dates
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Enumeration Date | 04/04/2013
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Last Update Date | 06/01/2021
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Provider Practice Location Address
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Address Line | 4401 S HARLEM AVE
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City | STICKNEY
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State | IL
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Zip | 60402-4250
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Country | US
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Telephone | 708-788-3400
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Fax | 708-788-3472
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Provider Business Mailing Address
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Address Line | 4401 S HARLEM AVE
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City | STICKNEY
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State | IL
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Zip | 60402-4250
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Country | US
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Telephone | 708-788-3400
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Fax | 708-788-3472
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 036152736
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207WX0120X
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Taxonomy Name | Cornea and External Diseases Specialist Physician
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License Number | 287768-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207WX0120X
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Taxonomy Name | Cornea and External Diseases Specialist Physician
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License Number | 036152736
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License Number State | IL
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