DR. PAUL CHRISTOPHER JACOBS (NPI# 1255326500) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255326500 |
| Entity Type | Individual |
| Full Name | DR. PAUL CHRISTOPHER JACOBS |
| Credential | O.D. |
| Practice Address |
1001 N Beadle Dr Suite 40 Carbondale IL 62901-1018 |
| Practice Telephone | 6185294817 |
| Practice Fax Number | 6183519024 |
| Mailing Telephone | 6185294817 |
| Mailing Fax Number | 6183519024 |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2013-08-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
046007399 | IL | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD MEDICARE PTAN | 410002083 | 01 | |
| RAILROAD MEDICARE PTAN | 410048999 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598912248 | Paul A Jacobs | Orthopaedic Surgery | 4641 N Lake Dr, Milwaukee, WI 53211-1255 | 2008-08-25 |
| 1619136173 | Paul Jacobs | Psychologist | 1 Horizon Rd, Apt. 1423, Fort Lee, NJ 07024-6502 | 2008-06-09 |
| 1619943347 | Paul C Jacobs | Optometrist | 7225 W Highway 71, Suite B, Austin, TX 78735-8350 | 2006-02-23 |
| 1841295243 | Paul Allen Jacobs | Obstetrics & Gynecology | 20 Medical Village Dr, Ste 302, Edgewood, KY 41017-5402 | 2005-06-14 |
| 1184149916 | Paul Jacobs | Case Manager/Care Coordinator | 520 Superior St, Port Huron, MI 48060-3838 | 2017-08-14 |
| 1376965020 | Paul Edward Jacobs | Physical Therapist | 3201 River Rd, Lewisburg, PA 17837-9255 | 2014-01-15 |
| 1659696979 | Paul Edward Jacobs | Anesthesiology | 3626 Ruffin Rd, San Diego, CA 92123-1810 | 2010-03-30 |
| 1326274820 | Paul Jerold Jacobs | Dentist | 429 S Lincoln Rd, Escanaba, MI 49829-1210 | 2009-06-10 |
| 1154541993 | Paul Walter Jacobs | Dentist | 3633 W Lake Ave, Suite 409, Glenview, IL 60026-5805 | 2007-04-26 |
| 1346328895 | Paul C Jacobs | Psychologist | 24255 W 13 Mile Rd, Suite 280, Bingham Farms, MI 48025-4320 | 2006-11-01 |
| Street Address |
1001 N BEADLE DR SUITE 40 |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901-1018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063621902 | Geoffrey Andrews Partlow II | Dentist | 1001 N Beadle Dr, Suite 1, Carbondale, IL 62901-1150 | 2007-05-21 |
| 1053488338 | Mazhar M. Butt | Dentist | 1001 N Beadle Dr, Carbondale, IL 62901-1150 | 2006-11-29 |
| 1558352641 | Paul C Jacobs Trevor Crabtree Ptr | Optometrist | 1001 N Beadle Dr, Ste 40, Carbondale, IL 62901-1018 | 2005-10-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| Taxonomy Code | 152WC0802X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Specialization | Corneal and Contact Management |
| The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea’s ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. |
| Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558352641 | Paul C Jacobs Trevor Crabtree Ptr | Optometrist | 1001 N Beadle Dr, Ste 40, Carbondale, IL 62901-1018 | 2005-10-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912516659 | Northwestern Medical Faculty Foundation | Optometrist | 2701 Patriot Blvd Fl 2, Glenview, IL 60026-8039 | 2020-07-29 |
| 1225697675 | Park Ridge Vision LLC | Optometrist | 350 S Northwest Hwy Ste 104, Park Ridge, IL 60068-4262 | 2019-06-10 |
| 1679131213 | Union Eyes, LLC | Optometrist | 15900 W 127th St Ste 221, Lemont, IL 60439-2914 | 2019-05-29 |
| 1508394933 | Awad Eyecare Sc | Optometrist | 1845 S Michigan Ave Unit 1803, Chicago, IL 60616 | 2017-05-30 |
| 1588063572 | Northwestern Medical Faculty Foundation | Optometrist | 259 E. Erie Street, Suite#02-220, Chicago, IL 60611-2661 | 2014-08-15 |
| 1962734129 | Boyce Family Eye Care, Ltd. | Optometrist | 528 Devon Ave, Park Ridge, IL 60068-4820 | 2010-02-12 |
| 1558546713 | Halsted Eye Boutique, Inc. | Optometrist | 2852 N Halsted St, Chicago, IL 60657-6531 | 2008-01-07 |
| 1114119609 | Kapoor Vision Consultants, Ltd | Optometrist | 1221 W Talon Ct, Palatine, IL 60067-1848 | 2007-08-17 |
| 1649475328 | Paul C Jacobs Trevor Crabtree Ptr | Optometrist | 223 N Park Ave, Herrin, IL 62948-3149 | 2007-06-20 |
| 1356559595 | Concept Eye Care, Ltd. | Optometrist | 1605 E 55th St, 1st Flr, Chicago, IL 60615-5803 | 2007-05-20 |
| Find all providers with the same taxonomy | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
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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.