Individual provider Active NPI

Alan C Jacobson, MD

  • Rheumatology Physician
  • Aurora, IL
National Provider Identifier
1770501900
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
036-112964 Issued in IL
Practice address
2285 Sequoia Dr
Aurora, IL 60506-6209
Phone
(630) 859-6942
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 036-112964 IL Primary

Addresses

Primary practice location

2285 Sequoia Dr
Aurora, IL 60506-6209

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other identifiers 2

IdentifierTypeStateIssuer
04515143OtherILBCBS#
036112964MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ajacobson206539@direct.myadvocateaurora.org
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20051227000253 IL Practitioner - RheumatologyPractitioner - Internal Medicine 5496784209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
State University of New York Downstate Medical Center, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2285 Sequoia Dr
Aurora, IL 60506-6209
Phone (630) 859-6800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-112964ILMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Oct 1, 2022 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Oct 1, 2022 Accepting new patients
Advocate Health and Hospitals Corporation Past Accepting new patients

Locations

2357 Sequoia Dr
Aurora, IL 60506
Phone (630) 859-6700

1221 N Highland Ave
Aurora, IL 60506
Phone (630) 859-6700

2285 Sequoia Dr
Aurora, IL 60506
Phone (630) 859-6700

28594 Network Pl
Chicago, IL 60673

Interoperability endpoints

  • Direct secure messaging: ajacobson206539@direct.myadvocateaurora.org

Organizations & group practices 3

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1770501900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2285 SEQUOIA DR",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605066209",
            "telephone_number": "630-859-6942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "ALAN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "IL",
            "license": "036-112964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS#",
            "identifier": "04515143",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036112964",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajacobson206539@direct.myadvocateaurora.org",
            "affiliation": "N",
            "address_1": "2285 Sequoia Dr",
            "city": "Aurora",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605066209",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2285 Sequoia Dr",
            "city": "Aurora",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605066209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

Verify at the official NPI Registry.