Daniel Raymond Jacobson, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

036075975 Issued in IL

Practice address

1413 W Lexington St
Chicago, IL 60607-4013

Phone

(312) 421-1226

Fax

(312) 421-1133

NPI assigned

Nov 10, 2005

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1447231063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 W LEXINGTON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074013",
            "telephone_number": "312-421-1133",
            "fax_number": "312-421-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 W LEXINGTON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074013",
            "telephone_number": "312-421-1226",
            "fax_number": "312-421-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "DANIEL",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036075975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN LICENSE",
            "identifier": "036075975",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anne Marie Jacobson, M.D.
• Ashley Jacobson, LPC
• Bailey Norman Jacobson, D.D.S., M.S.
• Beatriz Vera Jacobson
• Claire L Jacobson
• Danielle Jacobson
• Hannah Jacobson
• Jeffrey Randall Jacobson, M.D.
• Jenna Marie Jacobson, PA-C
• Karen Robson Jacobson, MA LCPC LMFT

• General Practice Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.