Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Anisha Jacob

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1801545116

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
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Practice location Address checks out

2160 S 1st Ave
Maywood, IL 60153-3328
Phone: (708) 216-9000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

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 number1801545116
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 22, 2022
Last updated in NPPESJune 12, 2026
Certification dateJune 12, 2026
Mailing address2160 S 1st Ave, Maywood, IL 60153-3328

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPATHOLOGY
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Accepts Medicare assignment Not indicated

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