Individual provider Active NPI

Chad E Jacobs, MD

  • Vascular Surgery Physician
  • Park Ridge, IL
National Provider Identifier
1801909213
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
036102397 Issued in IL
Practice address
1875 Dempster St Ste 550
Park Ridge, IL 60068-1188
Phone
(847) 384-1420
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 036102397 IL Primary

Addresses

Primary practice location

1875 Dempster St Ste 550
Park Ridge, IL 60068-1188

Mailing address

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

Other practice location 1

1875 W Dempster St
Suite 580
Park Ridge, IL 60068-1186
Phone (847) 384-1420

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address cjacobs205343@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address cjacobs205343@direct.myadvocateaurora.org Direct
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
I20040723000407 IL Practitioner - Vascular SurgeryPractitioner - General Surgery 7517947195 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
New York University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

1875 Dempster St
Park Ridge, IL 60068-1186
Phone (847) 723-8640

Hospital & facility affiliations

  • Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223
  • Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202
  • Advocate Sherman Hospital Hospital, Elgin, IL, CCN 140030

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal102
Leg revascularization (restoring blood flow)35
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jul 20, 2015 Accepting new patients
Cook County CurrentSince Nov 4, 2010 Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Jul 20, 2015 Accepting new patients
John H Stroger Jr. Hospital Pharmacy of Cook County CurrentSince Nov 4, 2010 Accepting new patients
Cook County Current Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

75 Remittance Dr
Ste 16
Chicago, IL 60675

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

29373 Network Pl
Chicago, IL 60673

1875 W Dempster St
Ste 550
Park Ridge, IL 60068
Phone (847) 384-1420

1875 W Dempster St
Ste 580
Park Ridge, IL 60068
Phone (847) 384-1420

1875 W Dempster St
Park Ridge, IL 60068
Phone (847) 723-8640

Interoperability endpoints

  • Direct secure messaging: cjacobs205343@direct.myadvocateaurora.org

Organizations & group practices 6

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 6

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1801909213",
    "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": "1875 DEMPSTER ST STE 550",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681188",
            "telephone_number": "847-384-1420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1875 W Dempster St",
            "address_2": "Suite 580",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "600681186",
            "country_code": "US",
            "telephone_number": "847-384-1420",
            "fax_number": "847-318-9332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBS",
        "first_name": "CHAD",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": "036102397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cjacobs205343@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1875 W Dempster St",
            "address_2": "Suite 580",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681186",
            "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": "1875 W Dempster St",
            "address_2": "Suite 580",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cjacobs205343@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1875 Dempster St Ste 550",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681188",
            "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": "1875 Dempster St Ste 550",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.