Provider Demographics
NPI:1356582118
Name:JACOBS, SUZANNE ELLEN (OTD, OTR/L)
Entity type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:ELLEN
Last Name:JACOBS
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Gender:F
Credentials:OTD, OTR/L
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Mailing Address - Street 1:1308 WAUKEGAN RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-3070
Mailing Address - Country:US
Mailing Address - Phone:847-486-4140
Mailing Address - Fax:847-486-4145
Practice Address - Street 1:1308 WAUKEGAN RD
Practice Address - Street 2:SUITE 103
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-3070
Practice Address - Country:US
Practice Address - Phone:847-486-4140
Practice Address - Fax:847-486-4145
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-09
Last Update Date:2010-04-05
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics