LISSIAMMA JACOB

PEORIA, IL
NPI1306835426
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207L00000X Anesthesiology
(Licence: IL  036054052)
Additional Taxonomies207LP2900X Anesthesiology, Pain Medicine
(Licence: IL  036054052)
207Q00000X Family Medicine
(Licence: IL  036054052)
Enumeration Date2005-10-20
Last Update Date2010-08-04
Business Address
Dr. LISSIAMMA JACOB MD
8600 N STATE ROUTE 91 SUITE 250
PEORIA, IL 61615-9541
Phone number: 309-692-5393
Mailing Address
Dr. LISSIAMMA JACOB MD
8600 N STATE ROUTE 91 SUITE 250
PEORIA, IL 61615-9541
Phone number: 309-692-5393