Jacob, Mark William

Jacob, Mark William is an sole proprietor health care provider with primary practice located at 4119 Dundee Rd , Northbrook IL 60062-2129. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Jacob, Mark William can be contacted via phone (847) 564-2180.

Contact Information

Primary practice address
4119 Dundee Rd Northbrook IL 60062-2129
Fax: (847) 564-2466
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X Illinois

Profile Details

NPI number 1275659955
LBN Legal business name Jacob, Mark William
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 22nd, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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