Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0127X | Trauma Surgeon | 036.149606 | IL |
NPI | 1467713248 |
---|---|
Provider Name | Dr. Jacob B. Avraham |
First Address | Skokie, IL 60076-5085 |
Second Address | Skokie, IL 60076-5085 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2012 |
Last Update Date | 18/11/2020 |