Provider Demographics
NPI:1215280987
Name:JACOME, ANABEL S
Entity type:Individual
Prefix:
First Name:ANABEL
Middle Name:S
Last Name:JACOME
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7877 W CAHILL TER
Mailing Address - Street 2:APT 3
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-2149
Mailing Address - Country:US
Mailing Address - Phone:872-220-3113
Mailing Address - Fax:773-629-8417
Practice Address - Street 1:7877 W CAHILL TER
Practice Address - Street 2:APT 3
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-2149
Practice Address - Country:US
Practice Address - Phone:872-220-3113
Practice Address - Fax:773-629-8417
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter