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1811979933
JACOB S LAKE
CHICAGO, IL
NPI
1811979933
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: IL 019016208)
Enumeration Date
2005-11-15
Last Update Date
2007-07-08
Business Address
Dr. JACOB S LAKE DDS
2806 W DEVON AVE
CHICAGO, IL 60659-1502
Phone number: 773-973-1100
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Mailing Address
Dr. JACOB S LAKE DDS
1800 MISSION HILLS RD
NORTHBROOK, IL 60062-5750
Phone number: 847-562-0808
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