Benjamin Lee Jacobson MD LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

BENJAMIN LEE JACOBSON MD LLC

Practice address

60 Revere Dr Ste 100
Northbrook, IL 60062-1590

Phone

(773) 266-6681

NPI assigned

Jul 20, 2021

Organization subpart

No

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

Authorized official

Name

Erin Alenciks

Title

Director of Psych Ops

Phone

(630) 363-2044

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626739200000",
    "number": "1457924284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 REVERE DR STE 100",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621590",
            "telephone_number": "773-266-6681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 REVERE DR STE 100",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621590",
            "telephone_number": "773-266-6681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENJAMIN LEE JACOBSON MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A",
        "authorized_official_last_name": "ALENCIKS",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "DIRECTOR OF PSYCH OPS",
        "authorized_official_telephone_number": "630-363-2044"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Behavioral Medicine Associates LTD.
• Jessica Behrens, RBT-19-82119
• Melissa Bellavia, BCBA
• Lynne C Belsky, MD
• Lisa Benedetto, LCPC
• Rivka Benjamin, LCSW
• Jessica Bennehoff, RBT-18-71152
• Cynthia Benner
• Marissa Bennett, BCBA
• Bruce Bennin, M.D.

• Psychiatry Physician in Northbrook, IL
• Providers in Northbrook, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.