| NPI | 1487630406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT A JACOBSEN Owner 847-362-1320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016-005031) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2014-07-25 |