Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACOB EDIBA
Active Sole ProprietorJACOB EDIBA is a Bus healthcare provider located in RANTOUL, Illinois. NPI 1871950782 is currently active in the NPPES registry. Verify at CMS.
Bus · RANTOUL, IL
Registration Details
- NPI Number
- 1871950782
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 22, 2016 (10.577489044046 yrs)
- Last Updated
- Nov 30, 2016
- License
-
MCS-10-0005-0464R1 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
273 KEYSTONE DR APT 5RANTOUL, IL, 618662774Browse IL providers · Browse ZIP 61866
- Phone
- 2174187384
- Primary Specialty
-
Bus
343900000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.