Mark C. Jacobson, M.D

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

036084954 Issued in IL

Practice address

911 N Elm St Ste 300
Hinsdale, IL 60521-3642

Phone

(630) 455-0456

NPI assigned

Jul 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Allergy/Immunology

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1990

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Allergy & Asthma Physicians, S. C

  • Allergy & Immunology Physician
  • Hinsdale, IL
  • NPI 1578662417
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1124059076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 N ELM ST STE 300",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213642",
            "telephone_number": "630-455-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 N ELM ST STE 300",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213642",
            "telephone_number": "630-455-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "MARK",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "IL",
            "license": "036084954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036084954",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronda Jaber
• Kinsey Meredith Jackson-Ford, CNM
• Alexis Jackson
• Tyra Jackson, FNP-BC
• Renee H Jacobs, MD
• Neeraj Jain, M.D.
• Ayisha Jameel, MD
• Jana Bergfeld LCSW, P.C
• Sahrish Javed
• Andrew Jedd, MA, MS

• Allergy & Immunology Physician in Hinsdale, IL
• Providers in Hinsdale, IL by specialty
• Allergy & Immunology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; 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.