Provider Demographics
NPI:1629378096
Name:TABEL, JAKE (MD)
Entity type:Individual
Prefix:DR
First Name:JAKE
Middle Name:
Last Name:TABEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 NATIONAL PKWY
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-5161
Mailing Address - Country:US
Mailing Address - Phone:847-884-9440
Mailing Address - Fax:
Practice Address - Street 1:955 NATIONAL PKWY
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-5161
Practice Address - Country:US
Practice Address - Phone:847-884-9440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-01
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036132237208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics