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

Dr. Lissiamma Jacob, MD

Individual provider Anesthesiology Physician · NPI 1306835426

Dr. Lissiamma Jacob, MD is an Anesthesiology Physician in Peoria, Illinois. Licensed in Illinois. Registered with an NPI since 2005.

Licensed in
IL
In the registry since
2005
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

8600 N State Route 91 Ste 250
Peoria, IL 61615-9541
Phone: (309) 692-5393
Fax: (309) 692-2538
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 036054052 (IL)
Pain Medicine (Anesthesiology) Physician Taxonomy 207LP2900X · Licence 036054052 (IL)
Family Medicine Physician Taxonomy 207Q00000X · Licence 036054052 (IL)

Record details

NPI number1306835426
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 20, 2005
Last updated in NPPESAugust 4, 2010

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