Tony, Jacob
Tony, Jacob is an individual health care provider with primary practice located at 900 Main St Ste 250 , Peoria IL 61602-5006. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Tony, Jacob can be contacted via phone (309) 672-4522.Contact Information
Primary practice address
900 Main St Ste 250
Peoria IL 61602-5006
Phone: (309) 672-4522
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 125-046927 | Illinois |
Profile Details
| NPI number | 1881815488 |
|---|---|
| LBN Legal business name | Tony, Jacob |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 1st, 2007 |
| Last updated | Nov 9th, 2017 - about 8 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 | 1881815488 | NPPES |
| Illinois | Other | 036119046 | LICENSE |
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