Individual provider Active NPI

Jeffery C Rubin, M.D.

  • Family Medicine Physician
  • Evanston, IL
National Provider Identifier
1124131768
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-091487 Issued in IL
Practice address
848 Dodge Ave Ste 228
Evanston, IL 60202-1506
Phone
(773) 671-8370
Fax
(815) 346-5803
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036091487 IL
Family Medicine Physician 207Q00000X 036-091487 IL Primary

Addresses

Primary practice location

848 Dodge Ave Ste 228
Evanston, IL 60202-1506

Mailing address

2280 Royal Oak CT
Cincinnati, OH 45237-2938
Phone (773) 671-8370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-091487ILMDFamily Medicine Physician
036091487ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois Family Medicine Past Accepting new patients
The Board of Trustees of the University of Illinois Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1124131768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2280 ROYAL OAK CT",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452372938",
            "telephone_number": "773-671-8370",
            "fax_number": "815-346-5803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "848 DODGE AVE STE 228",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602021506",
            "telephone_number": "773-671-8370",
            "fax_number": "815-346-5803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "JEFFERY",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036091487",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-091487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.