Nicole Jacques, LSW

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

115845 Issued in IL

Practice address

1860 W Winchester Rd Ste 106
Libertyville, IL 60048-5312

Phone

(262) 496-5863

NPI assigned

Dec 9, 2025

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1765238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1013870609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 16TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531404711",
            "telephone_number": "262-496-5863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 W WINCHESTER RD STE 106",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485312",
            "telephone_number": "262-496-5863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACQUES",
        "first_name": "NICOLE",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-09",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "115845",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "115845",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reena Jacob, DC
• Sapna Jacob, MD
• Brian J Jacobs, M.D.
• Lisa Jacobsen
• Scott Jacobsen, DPM
• Rachael Jaffe
• Amunn Jaffery, LSW
• Jagasia Audiology, Inc
• Akshay Jain
• Fahd Jajeh, MD

• Psychiatry Physician in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.