Anisha Jacob
Anisha Jacob is a Pathology in Maywood, Illinois. Qualified in 2012, 14 years ago. Works from 2 locations. Licensed in Illinois.
- Years since qualifying
- 14
- Licensed in
- IL
- In the registry since
- 2022
- Specialties on file
- 2
Practice location Address checks out
Maywood, ILNo coordinates on file. Search this address in Google Maps
Additional practice locations (1)
- 1402 S Grand Blvd, Saint Louis, MO 63104-1004 — (773) 658-7898
Specialties & licences
| Anatomic Pathology & Clinical Pathology Physician (primary) | Taxonomy 207ZP0102X · Licence 036178218 (IL) |
|---|---|
| Student in an Organized Health Care Education/Training Program | Taxonomy 390200000X |
Record details
| NPI number | 1801545116 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | March 22, 2022 |
| Last updated in NPPES | June 12, 2026 |
| Certification date | June 12, 2026 |
Medicare enrollment
| Medicare specialty | PATHOLOGY |
|---|---|
| Medical school | OTHER |
| Graduated | 2012 (14 years in practice) |
| Accepts Medicare assignment | Not indicated |
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