MEDICARE: MRS. LILA G JACOBS

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
1	235Z00000X	Speech-Language Pathologist	12828	NC

General Provider Information

NPI Number	:	1598835563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LILA G JACOBS

Provider Business Mailing Address
First Line	:	1312 EASTBOURNE DR
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28411-0028
Country	:	US
Telephone Number	:	815-922-1218
Fax Number	:

Provider Business Practice Location Address
First Line	:	2116 CAPITAL DR STE 100
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28405-6482
Country	:	US
Telephone Number	:	910-313-2111
Fax Number	:	910-313-2119

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	09/04/2025

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Directions to “ MRS. LILA G JACOBS ” Practice Location

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