Tricia Jacobs, SLP-CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.014028 Issued in IL

Practice address

1611 W Harrison St
Chicago, IL 60612-4861

Phone

(877) 632-6637

NPI assigned

Nov 13, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tricia Randolph Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1510531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510531200000",
    "number": "1720591704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 E 13TH ST APT 1408",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053250",
            "telephone_number": "708-528-7816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124861",
            "telephone_number": "877-632-6637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "TRICIA",
        "credential": "SLP-CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-13",
        "last_updated": "2017-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.014028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRICIA",
            "last_name": "RANDOLPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Natalie Jacobs, MD
• Norman Michael Jacobs, M.D.
• Rachel H Jacobs, PH.D.
• Ryan Charles Jacobs, MD
• Sarah Jacobs, PT, DPT
• Molly Jacobsen Hansen
• Amy Jacobsen
• Danielle Jacobsen
• Sydney Jacobsen
• Walter Jacobsen, DPM

• Speech-Language Pathologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2017; 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.