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1619396207
ANN JACOB
SPRINGFIELD, IL
NPI
1619396207
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: IL 125069375)
Enumeration Date
2014-04-10
Last Update Date
2018-09-26
Business Address
ANN JACOB
901 W JEFFERSON ST
SPRINGFIELD, IL 62702-4833
Phone number: 312-513-0307
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Mailing Address
ANN JACOB
PO BOX 19642 901 WEST JEFFERSON
SPRINGFIELD, IL 62794-9642
Phone number:
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