DR. SUSAN JACOB M.C. NPI 1831136019

NPI Information

NPI: 1831136019
Provider Name: DR. SUSAN JACOB, M.C.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual
Address:
303 E ARMY TRAIL RD
STE 410A
BLOOMINGDALE, IL
ZIP 60108
Phone: (630) 893-8161
Get Directions

DR. Susan Jacob, M.C. is a family medicine in Bloomingdale, IL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Susan Jacob, M.C. NPI is 1831136019. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

303 E ARMY TRAIL RD
STE 410A
BLOOMINGDALE, IL
ZIP 60108-169
Phone: (630) 893-8161
Fax: (630) 893-8564

The enumeration date for this NPI number is 5/31/2006 and was last updated on 3/7/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		036-110462	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	036-110462	MEDICAID	ILLINOIS
2	CN4921	OTHER		RRMC
3	209398	OTHER		GROUP MEDICARE PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »