Ronald Jacobson, D.D.S., M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

021001468 Issued in IL

Practice address

4200 W Peterson Ave
Suite 116
Chicago, IL 60646-6074

Phone

(773) 545-5333

Fax

(773) 545-3636

NPI assigned

Mar 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Jacobson Orthodontic Associates, LTD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Chicago, IL
  • NPI 1508006313
  NPD (past) Authorized official

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212969600000",
    "number": "1821120122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 W PETERSON AVE",
            "address_2": "SUITE 116",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606466074",
            "telephone_number": "773-545-5333",
            "fax_number": "773-545-3636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 W PETERSON AVE",
            "address_2": "SUITE 116",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606466074",
            "telephone_number": "773-545-5333",
            "fax_number": "773-545-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSON",
        "first_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2008-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "021001468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "01901183",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna Marie Jacobson, PA-C
• Karen Robson Jacobson, MA LCPC LMFT
• Melissa A Jacobson
• Phillip Albert Jacobson, M.D.
• Rebecca Wolf Jacobson, MSW, LCSW
• Tyler Andrew Jacobson
• Wynne Jacobson, LCPC
• Jacoby Chiropractic & Sports Performance
• Brian Joseph Jacoby, D.C.
• Candida Jacoby, LCSW

• Orthodontics and Dentofacial Orthopedics Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; 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.