Most Relevant Information
Provider Data
| NPI Number: | 1003818733 |
| Provider Name: | JACOB MANOJ KITCHENER MD |
| Entity Type: | Individual |
| Taxonomy Code: | 2084N0400X |
| Specialty: | Psychiatry & Neurology |
| License Number: | 2009027338 |
Most Important Dates
| Enumeration Date: | 08/12/2005 |
| Last Updated: | 03/13/2023 |
Provider Practice Location
421 N 9TH ST
SPRINGFIELD
IL
62702
Practice Location Phone/Fax
| Phone: | 2177576868 |
| Fax: | 1775768672 |
Provider Mailing Location
421 N 9TH ST
SPRINGFIELD
IL
627025317
Provider Mailing Phone/Fax
| Phone: | 2177576868 |
| Fax: | 1775768672 |
Suggested EMR
Neurology EMR