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NPI Code Detail

MEDICARE: REBECCA WOLF JACOBSON MSW, LCSW

MEDICARE:   REBECCA WOLF JACOBSON  MSW, LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker149.017896IL

General Provider Information

NPI Number : 1528581790
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA WOLF JACOBSON MSW, LCSW
Provider Business Mailing Address
First Line : 1827 N DAYTON ST UNIT E
Second Line :
City : CHICAGO
State : IL
Zip : 60614-0999
Country : US
Telephone Number : 847-421-9136
Fax Number :
Provider Business Practice Location Address
First Line : 1827 N DAYTON ST UNIT E
Second Line :
City : CHICAGO
State : IL
Zip : 60614-0999
Country : US
Telephone Number : 847-421-9136
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2017
Last Update Date : 07/21/2022

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Directions to “ REBECCA WOLF JACOBSON MSW, LCSW” Practice Location

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