Jerome Antoun Jabbour, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036119492 Issued in IL

Practice address

2310 York St
Suite 2 C
Blue Island, IL 60406-2411

Phone

(773) 809-3622

Fax

(773) 409-8659

NPI assigned

Aug 31, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: jjabbour218624@direct.myadvocateaurora.org

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.

• Indiana Health Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Indianapolis, IN
  • NPI 1942303086
  NPD (past)

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314057600000",
    "number": "1255325676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N MCCLURG CT",
            "address_2": "3806 A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113044",
            "telephone_number": "248-802-3842",
            "fax_number": "248-802-3842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 YORK ST",
            "address_2": "SUITE 2 C",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604062411",
            "telephone_number": "773-809-3622",
            "fax_number": "773-409-8659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JABBOUR",
        "first_name": "JEROME",
        "middle_name": "ANTOUN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2011-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01060708A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036119492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200525220",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hunters Healthcare Services and Delivery Limited
• I Can Hear U Now Inc
• Abbas M.B Ibrahim Sr.
• Illinois/Indiana Em-I Medical Services, S.C.
• Jill C Ingelse, O.D.
• Keshawn Jackson
• Petrina F Jackson, M.S., CCC-SLP
• Julie A Jansky, PHARM D
• Faheem M Jesani, D.O.
• Martin Jay Joffe, MD

• Family Medicine Physician in Blue Island, IL
• Providers in Blue Island, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; 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.