Active NPI
Abraham Jacob, PT
- Physical Therapist
- Oak Forest, IL
National Provider Identifier
1942497755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 5320 159TH St Ste 300
Oak Forest, IL 60452-3333 - Phone
- (708) 687-4747
- Fax
- (708) 687-4749
- NPI assigned
- Sep 26, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | IL | Primary |
Addresses
Primary practice location
5320 159TH St Ste 300
Oak Forest, IL 60452-3333
Mailing address
5320 159TH St Ste 300
Oak Forest, IL 60452-3333
Phone (708) 687-4747
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7602301 | Other | IL | AETNA |
| 1515389 | Other | IL | CIGNA |
| 1618642 | Other | IL | BC/ BS |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190764800000",
"number": "1942497755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5320 159TH ST STE 300",
"city": "OAK FOREST",
"state": "IL",
"postal_code": "604523333",
"telephone_number": "708-687-4747",
"fax_number": "708-687-4749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5320 159TH ST STE 300",
"city": "OAK FOREST",
"state": "IL",
"postal_code": "604523333",
"telephone_number": "708-687-4747",
"fax_number": "708-687-4749"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOB",
"first_name": "ABRAHAM",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-09-26",
"last_updated": "2007-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7602301",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1515389",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/ BS",
"identifier": "1618642",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oak Forest, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.