| Doctor Name: | MS. SUSAN D JACOBS |
| NPI Number: | 1013942218 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 149.007516 |
| Business Practice Address: | 1701 E Woodfield Rd Suite 1000 Schaumburg, IL - 601735113 |
| Business Phone Number: | 8472402211 |
| Business Fax Number: | 8472402418 |
| Mailing Address: | 1701 E Woodfield Rd, Suite 1000 SCHAUMBURG |
| State: | IL |
| Postal Code: | 601735905 |
| Phone Number: | 8472402211 |
| Fax Number: | 8472402418 |
| NPI Enumeration Date: | 07/12/2006 |
| NPI Last Update Date: | 08/13/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 149.007516 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |