DR. SUSAN JACOB (NPI# 1831136019) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831136019 |
| Entity Type | Individual |
| Full Name | DR. SUSAN JACOB |
| Other Name | MISS SUSAN JOHN |
| Credential | M.C. |
| Practice Address |
303 E Army Trail Rd Ste 410a Bloomingdale IL 60108-2169 |
| Mailing Address |
Po Box 7009 Bolingbrook IL 60440-7009 |
| Practice Telephone | 6308938161 |
| Practice Fax Number | 6308938564 |
| Mailing Telephone | 6308938161 |
| Mailing Fax Number | 6308938564 |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2011-03-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036-110462 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA | BJ8988214 | 01 | |
| RRMC | CN4921 | 01 | |
| IL | 036-110462 | 05 | |
| GROUP MEDICARE PTAN | 209398 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821468257 | Susan Jacob | Nurse Practitioner | 212 Angela Ln, Stafford, TX 77477 | 2015-09-28 |
| 1699865881 | Susan C Jacob | Allergy & Immunology | 801 Alma St, Tomball, TX 77375 | 2006-10-16 |
| 1245246503 | Susan M. Jacob | Counselor | 1101 Dove St, Suite 160, Newport Beach, CA 92660-2839 | 2006-07-31 |
| 1356964431 | Susan Jacob | Student in an Organized Health Care Education/Training Program | 3459 5th Ave Ste 9, Pittsburgh, PA 15213-3236 | 2020-05-22 |
| 1306315130 | Susan Jacob | Nurse Practitioner | 1380 River Bend Dr, Dallas, TX 75247-4914 | 2018-11-22 |
| 1801134390 | Susan Biji Jacob | Nurse Practitioner | 4400 N Lincoln Blvd, Oklahoma City, OK 73105-5104 | 2013-01-18 |
| 1487991246 | Susan Jacob | Pharmacist | 5473 Nw Saint James Dr, Port Saint Lucie, FL 34983-3444 | 2013-01-12 |
| 1467675819 | Susan Vivian Jacob | Psychologist | 14 Vanderventer Ave, Port Washington, NY 11050-3737 | 2007-04-11 |
| 1568685436 | Susan Jacob | Nurse Practitioner | 710 W 168th Street, New York, NY 10032-2699 | 2007-04-10 |
| 1538207220 | Susan Jacob | Family Medicine | 231 Albert Sabin Way, Cincinnati, OH 45267-2827 | 2007-02-02 |
| Street Address |
303 E ARMY TRAIL RD STE 410A |
| City | BLOOMINGDALE |
| State | IL |
| Zip Code | 60108-2169 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962403998 | Aziz Ahmed | Internal Medicine | 303 E Army Trail Rd, Suite 417, Bloomingdale, IL 60108-2169 | 2005-08-01 |
| 1639785314 | Podiatric Management Systems LLC | Podiatrist | 303 E Army Trail Rd, Bloomingdale, IL 60108-2169 | 2020-09-18 |
| 1053862201 | Jessica Claire Drew | Nurse Practitioner | 303 E Army Trail Rd, Suite 100, Bloomingdale, IL 60108-2169 | 2016-10-21 |
| 1003360306 | Jabri Medical Ltd. | Clinic/Center | 303 E Army Trail Rd, Suite 204, Bloomingdale, IL 60108-2169 | 2016-08-04 |
| 1407207947 | Ramina Nissan | Student in an Organized Health Care Education/Training Program | 303 E Army Trail Rd, Suite 200, Bloomingdale, IL 60108-2169 | 2016-06-27 |
| 1417307901 | Naz Fatima Rizvi | Optometrist | 303 E Army Trail Rd, Suite 200, Bloomingdale, IL 60108-2169 | 2016-06-15 |
| 1316322720 | Melissa Jo Valeska Mckinney | Specialist/Technologist | 303 E Army Trail Rd, Ste 400, Bloomingdale, IL 60108-2169 | 2015-07-27 |
| 1881087856 | Accelerated Rehabilitation Centers, Ltd | Physical Therapist | 303 E Army Trail Rd, #400, Bloomingdale, IL 60108-2169 | 2015-03-14 |
| 1780094854 | Adventist Health Partners, Inc. | Internal Medicine | 303 E Army Trail Rd, Ste 203, Bloomingdale, IL 60108-2169 | 2014-04-29 |
| 1023446408 | Chicagoland Hearing | Clinic/Center | 303 E Army Trail Rd, Suite 200, Bloomingdale, IL 60108-2169 | 2013-10-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437758711 | Gina Baldacci, Lcsw, LLC | Community/Behavioral Health | 231 Longridge Dr, Bloomingdale, IL 60108 | 2020-10-19 |
| 1366056731 | Morgan Proctor | Physical Medicine & Rehabilitation | West Suburban Nursing and Rehabilitation, 311 Edgewater Drive, Bloomingdale, IL 60108 | 2020-09-03 |
| 1427549427 | Soohee Choi | Nurse Practitioner | 303 E Army Trail Rd Ste 100, Bloomingdale, IL 60108 | 2018-05-24 |
| 1427571710 | Priya Sanil Mathew | Nurse Practitioner | 151 Los Lagos Dr, Bloomingdale, IL 60108 | 2017-07-19 |
| 1538610100 | Saher Sayed | Optometrist | 102 Stratford Dr., Bloomingdale, IL 60108 | 2016-10-19 |
| 1215388939 | Kathy Mcnulty, Lcsw, LLC | Community/Behavioral Health | 1 Tiffany Point, Suite 117, Bloomingdale, IL 60108 | 2016-06-23 |
| 1689023889 | Agnes G Nawrot | Nurse Practitioner | 348 Golfview Court, Bloomingdale, IL 60108 | 2016-06-08 |
| 1023484045 | Amber Cotter | Social Worker | 203 Regency Drive, Unit 519, Bloomingdale, IL 60108 | 2015-08-13 |
| 1891176988 | Gunveen Chawla | Dentist | 366 W Army Trail Rd Ste 310a, Bloomingdale, IL 60108 | 2015-06-15 |
| 1922492396 | Allison Marie Schnitzler | Family Medicine | 245 S Gary Ave Ste 100, Bloomingdale, IL 60108 | 2015-03-24 |
| Find all providers in zip 60108 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922492396 | Allison Marie Schnitzler | Family Medicine | 245 S Gary Ave Ste 100, Bloomingdale, IL 60108 | 2015-03-24 |
| 1376842914 | Family Medicine Group LLC | Family Medicine | 73 Clark St, Bloomingdale, NJ 07403-1300 | 2011-03-22 |
| 1942482146 | Bloomingdale Family Practice S.c | Family Medicine | 245 S Gary Ave Ste 204, Bloomingdale, IL 60108-2218 | 2007-11-29 |
| 1043431661 | Frank B Fung | Family Medicine | 235 S Gary Avenue, Bloomingdale, IL 60108 | 2007-05-01 |
| 1104965557 | Marcia E Neil | Family Medicine | 235 S Gary Ave, Cdh Convenient Care At Stratford North, Bloomingdale, IL 60108-2213 | 2007-02-05 |
| 1609807908 | Michael F Vosicky | Family Medicine | 290 Springfield Dr Ste 290, Bloomingdale, IL 60108-2293 | 2006-07-05 |
| 1073549424 | Stratford Physical Medicine Ltd | Family Medicine | 290 Springfiled Drive, Suite 255, Bloomingdale, IL 60108-2293 | 2006-06-25 |
| 1740225267 | Adventist Health Partners,inc | Family Medicine | 129 Fairfield Way, Suite 116, Bloomingdale, IL 60108-1560 | 2006-06-18 |
| 1013968239 | Imelda Andaya Sia | Family Medicine | 113 W Lake St, Bloomingdale, IL 60108-1006 | 2006-05-12 |
| 1881652188 | Eric D. Beachy | Family Medicine | 201 W Academy St, Bloomingdale, IN 47832-8095 | 2006-05-03 |
| Find all providers in BLOOMINGDALE | ||||
| City | BLOOMINGDALE |
| Zip Code | 60108 |
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| 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.