| Jeena Jacob Inc. | |
|
1721 Moon Lake Blvd Ste 150 Hoffman Estates IL 60169-1069 | |
| (847) 519-3650 | |
| (847) 519-3652 |
| Full Name | Jeena Jacob Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 1721 Moon Lake Blvd Ste 150, Hoffman Estates, Illinois |
| Authorized Official Name and Position | Jeena George Jacob (PRESIDENT) |
| Authorized Official Contact | 8479128958 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeena Jacob Inc. 1173 Ancient Oaks Ct Bartlett IL 60103-1711 Ph: (847) 912-8958 | Jeena Jacob Inc. 1721 Moon Lake Blvd Ste 150 Hoffman Estates IL 60169-1069 Ph: (847) 519-3650 |
| NPI Number | 1275705592 |
|---|---|
| Provider Enumeration Date | 03/26/2008 |
| Last Update Date | 03/26/2008 |
| Medicare PECOS PAC ID | 8820088537 |
|---|---|
| Medicare Enrollment ID | O20040514000732 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275705592 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (Illinois) | Primary |
| Provider Name | Jeena G Jacob |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114947066 PECOS PAC ID: 2264422971 Enrollment ID: I20040514000919 |
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