Sheby Elsa Jacob, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.027902 Issued in IL

Practice address

1715 E 95TH St
Chicago, IL 60617-4708

Phone

(773) 977-7256

NPI assigned

Jul 13, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Unity Hospice of Chicagoland LLCGroup PAC ID 0840210019, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Unity Hospice of Chicagoland LLC

  • Community Based Hospice Care Agency
  • Chicago, IL
  • NPI 1598844474

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Oak Street Health Physicians Group, PC

  • Primary Care Clinic/Center
  • Chicago, IL
  • NPI 1083051643

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1689206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1407535826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 E 95TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174708",
            "telephone_number": "832-818-7251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 E 95TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174708",
            "telephone_number": "773-977-7256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "SHEBY",
        "middle_name": "ELSA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-13",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "041.545102",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.027902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jino Jacob, OT
• Kevin Chacko Jacob, MD
• Mercedita C Jacob, M.D.
• Preston R Jacob, M.D.
• Ross Jacob, LCSW
• Sherin M Jacob
• Tiffany Sunny Jacob
• Tobin Jacob
• Daniel Joseph Jacobazzi, P.T.
• Christine L. Jacobek, PSY.D.

• Family Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.