Active NPI
Benjamin Jacobson, M.D.
- Psychiatry Physician
- Lake Forest, IL
National Provider Identifier
1841428950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 036.141223
- Practice address
- 700 N Westmoreland Rd Ste a
Lake Forest, IL 60045-1672 - Phone
- (847) 234-5600
- NPI assigned
- Jun 26, 2009
- Last updated
- Jul 15, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 036.141223 | IL | Primary |
| Psychiatry Physician | 2084P0800X | MD15357 | RI |
Addresses
Primary practice location
700 N Westmoreland Rd Ste a
Lake Forest, IL 60045-1672
Mailing address
700 N Westmoreland Rd Ste a
Lake Forest, IL 60045-1672
Phone (847) 234-5600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.141223 | IL | MD | Psychiatry Physician |
| MD15357 | RI | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Dupage Physician Group | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Northwestern Medicine Regional Medical Group
- Family Medicine Physician
- Carol Stream, IL
- NPI 1033149844
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468540800000",
"number": "1841428950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 N WESTMORELAND RD STE A",
"city": "LAKE FOREST",
"state": "IL",
"postal_code": "600451672",
"telephone_number": "847-234-5600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 N WESTMORELAND RD STE A",
"city": "LAKE FOREST",
"state": "IL",
"postal_code": "600451672",
"telephone_number": "847-234-5600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBSON",
"first_name": "BENJAMIN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-26",
"last_updated": "2016-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "036.141223",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "RI",
"license": "MD15357",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Forest, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.