| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JAKOV TIEFENBACH | 1053161992 | 2024-10-13 |
Jakov Tiefenbach is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1053161992. Registration indicates Jakov Tiefenbach is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care)
| Entity Type | Individual |
| Provider Name | Jakov Tiefenbach MBCHB |
| Practice Office Address | 820 S WOOD ST STE 100 CHICAGO, IL US |
| Practice Office Telephone | 3129962933 |
| Mailing Address | 820 S WOOD ST STE 100 CHICAGO, IL 606124325 US |
| Business Telephone | 3129962933 |
| Code | Practice | License No State |
|---|---|---|
| 390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care |