DR. Ellen Jacobsen, M.D.

NPI #1821092891 in Urbana, Illinois

Provider Information

NPI Number: 1821092891
Entity Type: Individual
Name: DR. Ellen Jacobsen, M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: M.D.
Enumeration Date: Jun 8, 2005
Last Updated: Jul 8, 2007

Practice Location

Address: 407 W SPRINGFIELD AVE
City: Urbana
State: Illinois
ZIP Code: 61801-8809
Phone: (217) 367-7546

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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