Jacobs, Kristen
Jacobs, Kristen is an individual health care provider with primary practice located at 329 Broadway St , Mount Vernon IL 62864-5115. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Jacobs, Kristen can be contacted via phone (618) 244-3370.Contact Information
Primary practice address
329 Broadway St
Mount Vernon IL 62864-5115
Phone: (618) 244-3370
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | Illinois |
Profile Details
| NPI number | 1457302655 |
|---|---|
| LBN Legal business name | Jacobs, Kristen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 12th, 2006 |
| Last updated | Jul 24th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457302655 | NPPES |
| Illinois | MEDICAID | 376020408007 |
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