IndividualActive
Mark Jacob
NPI 1659486751 · Oral & Maxillofacial Surgery (D.M.D.) · Highland Park, IL
Provider details
- NPI number
- 1659486751
- Entity type
- Individual
- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.)Allopathic & Osteopathic Physicians
- Sex
- Male
- Sole proprietor
- No
- License
- 021.002059 (IL)
Practice location
1893 Sheridan Rd Ste 311
Highland Park, IL 60035-2646
Phone: (847) 433-6636
Fax: (847) 433-2090
Mailing address
809 S Marshfield Ave
Chicago, IL 60612-4305
Registry dates
- Enumerated
- 2006-08-20
- Last updated
- 2023-12-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.