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NPI Code Detail

MEDICARE: HANNAH JACOBSON

MEDICARE: HANNAH JACOBSON
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
1363LF0000XFamily Nurse Practitioner209013975IL

General Provider Information

NPI Number : 1881057479
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH JACOBSON
Provider Business Mailing Address
First Line : 2318 S CENTRAL PARK AVE # 101
Second Line :
City : CHICAGO
State : IL
Zip : 60623-3101
Country : US
Telephone Number : 312-909-0075
Fax Number :
Provider Business Practice Location Address
First Line : 3517 W ARTHINGTON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60624-4165
Country : US
Telephone Number : 872-588-3510
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2016
Last Update Date : 03/31/2016

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Directions to “ HANNAH JACOBSON ” Practice Location

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