Active NPI
John Jacobsen
- Neurology Physician
- Oak Park, IL
National Provider Identifier
1477548477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- Practice address
- 1 Erie CT
Suite 7020
Oak Park, IL 60302-2566 - Phone
- (630) 789-2550
- NPI assigned
- Sep 15, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | IL | Primary |
Addresses
Primary practice location
1 Erie CT
Suite 7020
Oak Park, IL 60302-2566
Mailing address
777 Oakmont LN
Suite 1600
Westmont, IL 60559-5511
Phone (630) 288-6215
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-063370 | IL | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Suburban Hospital Medical Center | Past | Accepting new patients | |
| West Suburban Medical Center | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Skilled Nursing Facility
- Oak Park, IL
- NPI 1538206974
-
- Family Medicine Physician
- Chicago, IL
- NPI 1649499096
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477548477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 OAKMONT LN",
"address_2": "SUITE 1600",
"city": "WESTMONT",
"state": "IL",
"postal_code": "605595511",
"telephone_number": "630-288-6215",
"fax_number": "630-214-9344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 ERIE CT",
"address_2": "SUITE 7020",
"city": "OAK PARK",
"state": "IL",
"postal_code": "603022566",
"telephone_number": "630-789-2550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBSEN",
"first_name": "JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.