Ambili Mariam Jacob
Ambili Mariam Jacob is a Nurse Practitioner in Lake Barrington, Illinois. Qualified in 2024, 2 years ago. Practices with George N Atia MD SC, a 12-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Illinois.
- Years since qualifying
- 2
- Licensed in
- IL
- In the registry since
- 2024
- Specialties on file
- 3
Practice location Address checks out
22285 N Pepper Rd Ste 409Lake Barrington, IL 60010-2542
Phone: (847) 382-7165
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Nurse Practitioner (primary) | Taxonomy 363L00000X · Licence 209.030952 (IL) |
|---|---|
| Registered Nurse | Taxonomy 163W00000X · Licence 041410871 (IL) |
| Student in an Organized Health Care Education/Training Program | Taxonomy 390200000X |
Record details
| NPI number | 1275369126 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | September 9, 2024 |
| Last updated in NPPES | May 16, 2025 |
| Certification date | May 16, 2025 |
Medicare enrollment
| Medicare specialty | NURSE PRACTITIONER |
|---|---|
| Medical school | OTHER |
| Graduated | 2024 (2 years in practice) |
| Group practice | George N Atia Md Sc — 12 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Telehealth | Offers telehealth services |