JEFFREY RANDALL JACOBSON


Address: 909 South Wolcott Avenue, 3141 Comrb, Chicago, IL 60612-3725
Phone: 3129968039

JEFFREY RANDALL JACOBSON (NPI# 1609937432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1609937432
Entity Type Individual
Full Name JEFFREY RANDALL JACOBSON
Credential M.D.
Practice Address 909 South Wolcott Avenue
3141 Comrb
Chicago
IL 60612-3725
Practice Telephone 3129968039
Practice Fax Number 3129964665
Mailing Telephone 3129968039
Mailing Fax Number 3129964665
Enumeration Date 2006-12-13
Last Update Date 2010-03-04
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207RC0200X Internal Medicine
Specialization: Critical Care Medicine
036.114116 IL Allopathic & Osteopathic Physicians
Y 207RP1001X Internal Medicine
Specialization: Pulmonary Disease
036.114116 IL Allopathic & Osteopathic Physicians
N 207RP1001X Internal Medicine
Specialization: Pulmonary Disease
036114116 IL Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
IL 036114116 05

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Office Location

Street Address 909 SOUTH WOLCOTT AVENUE
3141 COMRB
City CHICAGO
State IL
Zip Code 60612-3725

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
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1578183414 Zachary Belden Student in an Organized Health Care Education/Training Program Uic Psychiatry Residency 912 S. Wood St., Rm 130b Npi-s (mc 913), Chicago, IL 60612 2020-04-21
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Taxonomy Information

Taxonomy Code 207RP1001X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Pulmonary Disease

Taxonomy Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

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1427194638 Diane Tate Internal Medicine 6547 N Avondale Ave, Suite 001, Chicago, IL 60631-1573 2007-01-29
1760534192 Anita A Shah Internal Medicine 2800 N Sheridan Rd Ste 301, Chicago, IL 60657-6158 2007-01-17
1891853016 Romeo Lee Uy Internal Medicine 5140 North California Ave, Suite 620, Chicago, IL 60625 2006-12-04
1861560724 Alvin Jerry Schonfeld Internal Medicine 438 W Saint James Pl, Chicago, IL 60614-2750 2006-11-30
1154405801 Nicholas Gross Internal Medicine 1414 N Wells St, Apt. 407, Chicago, IL 60610-1374 2006-10-25
1285724765 Howard Arya Jaffe Internal Medicine 820 South Damen Street, Pccsm, Dept Med (111), Jesse Brown Va Medical Center, Chicago, IL 60612 2006-10-13
1346340650 Ricky Johnson Internal Medicine 2011 E 75th St, Chicago, IL 60649-3607 2006-09-25
1215041462 Patricia S Mikes Md Sc Internal Medicine 201 E Huron St Ste 11-245, Chicago, IL 60611-2867 2006-08-17
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City CHICAGO
Zip Code 60612

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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