Carolyn Jacob in Chicago - Procedural Dermatology
Carolyn Jacob - NPI 1265498083
Carolyn Jacob is a Procedural Dermatology in Chicago, Illinois. Carolyn Jacob practices all healthcare services and medical treatments related to Procedural Dermatology. The NPI Number for Carolyn Jacob is 1265498083. The last update date is 2020-02-05.
Carolyn Jacob's current location address is 515 N State St Ste 900, Chicago, Illinois. You can contact this provider via phone number 3122459965 and fax number 3122459964. The mailing address for Carolyn Jacob is 515 N State St Ste 900, Chicago, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Carolyn Jacob |
|---|---|
| Address | 515 N State St Ste 900, Chicago, Illinois |
| Phone Number | 3122459965 |
| Fax Number | 3122459964 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1265498083 |
|---|---|
| Provider Enumeration Date | 2006-04-21 |
| Last Updated Date | 2020-02-05 |
Provider Mailing Address Detail
| Address | 515 N State St Ste 900 |
|---|---|
| City | Chicago |
| State | Illinois (IL) |
| Post Code | 606549104 |
| Phone Number | 3122459965 |
| Fax Number | 3122459964 |
Provider's Primary Taxonomy Detail
| Speciality | Procedural Dermatology |
|---|---|
| Taxonomy | 207Ns0135X |
| Licence No | 36102098 |
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Definition: Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surge |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 36102098 | IL | -- |
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What is the unique identifier code issued to Carolyn Jacob by the Centers for Medicare & Medicaid Services?
The Carolyn Jacob has been assigned the NPI (National Provider Identifier) 1265498083. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Where is the Carolyn Jacob located?
The Carolyn Jacob is located at 515 N State St Ste 900, Chicago, IL 606549104.
What is Carolyn Jacob's area of expertise and its corresponding taxonomy classification?
The Carolyn Jacob's field of specialization is Procedural Dermatology, and it falls under the taxonomy code 207Ns0135X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services assign the 1265498083 to Carolyn Jacob?
The Centers for Medicare & Medicaid Services assigned the 1265498083 to Carolyn Jacob on 2006-04-21.
As of what date were the Carolyn Jacob's details last updated?
The information pertaining to the Carolyn Jacob, including its address, specialty, and other details, was most recently updated on 2020-02-05.