Jonker Casper Jacobs, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

019032784 Issued in IL

Practice address

820 Davis St Ste 460
Evanston, IL 60201-4447

Phone

(847) 332-2226

NPI assigned

Jul 8, 2020

Sex

Male

Sole proprietor

No

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Procare Dental Group, P.C.

  • Dentist
  • Evanston, IL
  • NPI 1841357084
  NPD (past)

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1770101560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 WOODBINE AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011565",
            "telephone_number": "847-971-4360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 DAVIS ST STE 460",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014447",
            "telephone_number": "847-332-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "JONKER",
        "middle_name": "CASPER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-08",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019032784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Jackson
• Tracy I Jackson, APRN, FNP-BC
• Dalia T. Jacob, MD
• Jaimy Jacob, APN-CNP
• Beth Jacobs, PH.D.
• Kelly Marie Jacobs, LCSW, PMH-C
• Andrew Jaeger, MD
• Arshia Jafar Nia, DMD
• Harry Jay Jaffe, MD
• Marla Jaffe, OTR/L

• Dentist in Evanston, IL
• Providers in Evanston, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.