Individual provider Active NPI

Jacob Robert Malakismail, MD

  • Urology Physician
  • Chicago, IL
National Provider Identifier
1659170074
Registry record updated Sep 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
125.087876 Issued in IL
Practice address
1969 W Ogden Ave
Chicago, IL 60612-3765
Phone
(312) 864-6000
NPI assigned
Mar 10, 2025
Last updated
Sep 20, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 125.087876 IL Primary

Addresses

Primary practice location

1969 W Ogden Ave
Chicago, IL 60612-3765

Mailing address

117 Dorshire CT
Schaumburg, IL 60193-6142
Phone (847) 732-3408

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125.087876ILMDUrology Physician

NPI Registry JSON

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

{
    "created_epoch": "1741564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789862400000",
    "number": "1659170074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 DORSHIRE CT",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601936142",
            "telephone_number": "847-732-3408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1969 W OGDEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123765",
            "telephone_number": "312-864-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALAKISMAIL",
        "first_name": "JACOB",
        "middle_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-10",
        "last_updated": "2026-09-20",
        "certification_date": "2026-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IL",
            "license": "125.087876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2026; 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.