Active NPI
Eunice Sajan Jacob-Charly, DO
- Internal Medicine Physician
- Elgin, IL
National Provider Identifier
1689105413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036.151197
- Practice address
- 2250 Point Blvd Ste 140
Elgin, IL 60123-7869 - Phone
- (224) 212-0205
- Fax
- (224) 253-4973
- NPI assigned
- Mar 23, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036.151197 | IL | Primary |
Addresses
Primary practice location
2250 Point Blvd Ste 140
Elgin, IL 60123-7869
Mailing address
2250 Point Blvd Ste 140
Elgin, IL 60123-7869
Phone (224) 212-0205
Other names 1
- Dr. Eunice Sajan Jacob
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Feb 10, 2025 through Feb 10, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.151197 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jacob-Charly Medical.PLLC | Current | Accepting new patients |
Locations
2250 Point Blvd
Ste 140
Elgin, IL 60123
Phone (224) 212-0205
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745798400000",
"number": "1689105413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2250 POINT BLVD STE 140",
"city": "ELGIN",
"state": "IL",
"postal_code": "601237869",
"telephone_number": "224-212-0205",
"fax_number": "224-253-4973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2250 POINT BLVD STE 140",
"city": "ELGIN",
"state": "IL",
"postal_code": "601237869",
"telephone_number": "224-212-0205",
"fax_number": "224-253-4973"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOB-CHARLY",
"first_name": "EUNICE",
"middle_name": "SAJAN",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-03-23",
"last_updated": "2025-04-28",
"certification_date": "2025-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036.151197",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "EUNICE",
"last_name": "JACOB",
"middle_name": "SAJAN",
"prefix": "DR.",
"credential": "D.O",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Elgin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.