Ann Jacob

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

125069375 Issued in IL

Practice address

901 W Jefferson St
Springfield, IL 62702-4833

Phone

(312) 513-0307

NPI assigned

Apr 10, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Illinois Center for Neurological and Behavioral Medicine LTDGroup PAC ID 5698131670, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202
• Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Illinois Center for Neurological and Behavioral Medicine LTD

  • Psychiatry Physician
  • Des Plaines, IL
  • NPI 1649824459
  Medicare reassignment Care Compare group NPD
• Advance Psychiatry & Counseling, SC.

  • Psychiatry Physician
  • Bloomingdale, IL
  • NPI 1669563789
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Advocate Condell Medical Center

  • Mobile Mammography Clinic/Center
  • Gurnee, IL
  • NPI 1023262441

  Hospital

  Care Compare affiliation
• Advocate Condell Medical Center

  • General Acute Care Hospital
  • Libertyville, IL
  • NPI 1124272547
  Care Compare affiliation
• Advocate Condell Medical Center

  • Mobile Mammography Clinic/Center
  • Grayslake, IL
  • NPI 1770737199

  Hospital

  Care Compare affiliation
• Advocate Health and Hospitals Corporation

  • General Acute Care Hospital
  • Park Ridge, IL
  • NPI 1164539730
  Care Compare affiliation

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1619396207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19642",
            "address_2": "901 WEST JEFFERSON",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W JEFFERSON ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627024833",
            "telephone_number": "312-513-0307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOB",
        "first_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-10",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "125069375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Leon Jackson, PH.D.
• Ruth V Jackson, NNP
• Shawnee Jackson, RBT
• Tracy Jackson, RN
• Waylon Colby Jackson, CRNA, CPNP-AC, CCRN
• Benjamin Jacobs, RBT
• Sarah Ann Jacobs, DDS
• Adrienne L Jacobson, M.A., B.C.B.A.
• Donald L Jacoby, RPH
• Kathleen Sue Jacoby, R.PH.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; 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.