| Jacobson Orthodontic Associates, Ltd | |
|
4200 W Peterson Ave Suite 116 Chicago IL 60646-6074 | |
| (773) 545-5333 | |
| (773) 545-3636 |
| Full Name | Jacobson Orthodontic Associates, Ltd |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 4200 W Peterson Ave, Chicago, Illinois |
| Authorized Official Name and Position | Ronald Scott Jacobson (PRESIDENT) |
| Authorized Official Contact | 7735455333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacobson Orthodontic Associates, Ltd 4200 W Peterson Ave Suite 116 Chicago IL 60646-6074 Ph: (773) 545-5333 | Jacobson Orthodontic Associates, Ltd 4200 W Peterson Ave Suite 116 Chicago IL 60646-6074 Ph: (773) 545-5333 |
| NPI Number | 1508006313 |
|---|---|
| Provider Enumeration Date | 03/06/2009 |
| Last Update Date | 03/06/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508006313 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 060.004616 (Illinois) | Primary |
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