Active NPI
Tanya Jacobson, LMT ABT
- Massage Therapist
- Mundelein, IL
National Provider Identifier
1174926588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 227010146
- Practice address
- 1621 Pauline Cir
Mundelein, IL 60060-4128 - Phone
- (847) 877-1795
- NPI assigned
- Sep 29, 2014
- Last updated
- Sep 29, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 227010146 | IL | Primary |
Addresses
Primary practice location
1621 Pauline Cir
Mundelein, IL 60060-4128
Mailing address
1621 Pauline Cir
Mundelein, IL 60060-4128
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 227010146 | IL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411948800000",
"number": "1174926588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1621 PAULINE CIR",
"city": "MUNDELEIN",
"state": "IL",
"postal_code": "600604128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1621 PAULINE CIR",
"city": "MUNDELEIN",
"state": "IL",
"postal_code": "600604128",
"telephone_number": "847-877-1795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBSON",
"first_name": "TANYA",
"credential": "LMT ABT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-29",
"last_updated": "2014-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "IL",
"license": "227010146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mundelein, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.