Jeena George Jacob, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071-006551 Issued in IL

Practice address

1173 Ancient Oaks CT
Bartlett, IL 60103-1711

Phone

(847) 912-8958

NPI assigned

Jul 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jeena Jacob Inc.

  • Clinical Psychologist
  • Hoffman Estates, IL
  • NPI 1275705592
  Medicare reassignment NPD Authorized official
• Affiliated Clinical Psychologists Limited

  • Psychologist
  • Bloomingdale, IL
  • NPI 1457547457
  NPD (past)
• Center for Integrative and Functional Health and Wellness LLC

  • Multi-Specialty Clinic/Center
  • Bloomingdale, IL
  • NPI 1649748674
  NPD (past)
• Davken Associates, P.C.

  • Clinical Psychologist
  • Deerfield, IL
  • NPI 1457393159
  NPD (past)
• Neurohealth Associates PC

  • Clinical Neuropsychologist
  • Oak Brook, IL
  • NPI 1295809630
  NPD (past)

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199232000000",
    "number": "1114947066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1173 ANCIENT OAKS CT",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601031711",
            "telephone_number": "847-912-8958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1173 ANCIENT OAKS CT",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601031711",
            "telephone_number": "847-912-8958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "JEENA",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2008-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-006551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Syed Najeeb Husain, M.D.
• Hannah Hutchison
• Maha Ibrahim, M.B.B.CH/M.S./PHD
• J.L. Wu, D.P.M., P.C.
• Maria Jabri
• Qamar Jalil, M.D.
• James P. Economos, D.D.S., P.C.
• James Yonkee O.D. Inc.
• Hannah Grace Jameson, PHARMD
• Jamie Hofmeister DDS PLLC

• Clinical Psychologist in Bartlett, IL
• Providers in Bartlett, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.