Mark E Jacobs
Chiropractor
405 W Main St
Genoa
, Illinois 60135-1164
Mark E Jacobs
Chiropractor
405 W Main St
Genoa
, Illinois 60135-1164
(815) 784-4454
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About
Features
Specialties
- Chiropractor
Languages spoken
- English
Location
First Address
- Mark E Jacobs
- 405 W Main St
- Genoa, IL
- Zip : 60135-1164
- Fax : (815) 784-4454
- Phone : (815) 784-4455
Second Address
- Mark E Jacobs
- 405 W Main St
- Genoa, IL
- Zip : 60135-1164
- Fax : (815) 784-4454
- Phone : (815) 784-4455
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 038008275 | IL |
National Provider Identifier
| NPI | 1003834326 |
|---|---|
| Provider Name | Mark E Jacobs |
| First Address | Genoa, IL 60135-1164 |
| Second Address | Genoa, IL 60135-1164 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/07/2006 |
| Last Update Date | 03/08/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 01921720 | BLUE CROSS/BLUE SHIELD IL (01) | IL |
| 350045727 | TRICARE MEDICARE (01) | IL |
| U68219 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.