JUSTIN JACOBSON


Address: 1340 Charles St Ste 100, Rockford, IL 61104
Phone: 7796961900

JUSTIN JACOBSON (NPI# 1528478104) 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) 1528478104
Entity Type Individual
Full Name JUSTIN JACOBSON
Credential PA
Practice Address 1340 Charles St Ste 100
Rockford
IL 61104
Mailing Address Po Box 78866
Milwaukee
WI 53278-8866
Practice Telephone 7796961900
Enumeration Date 2014-05-05
Last Update Date 2019-10-02
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant 085-005085 IL Physician Assistants & Advanced Practice Nursing Providers

Other Providers JUSTIN JACOBSON

NPI Name Taxonomy Address Enumeration
1578572129 Justin A. Jacobson Orthopaedic Surgery 2831 Fort Missoula Road, Suite 232, Missoula, MT 59804 2006-08-05
1457950529 Justin Jacobson Student in an Organized Health Care Education/Training Program 750 N Freedom Blvd, Provo, UT 84601-1677 2020-10-20

Office Location

Street Address 1340 CHARLES ST STE 100
City ROCKFORD
State IL
Zip Code 61104

Providers in the same location

NPI Name Taxonomy Address Enumeration
1689729535 Swedishamerican Hospital Nurse Practitioner 1340 Charles St Ste 100, Rockford, IL 61104 2007-01-23
1598310849 Catherine M Bopp Physician Assistant 1340 Charles St Ste 100, Rockford, IL 61104-2200 2019-08-05
1851763700 Megan Buja Physician Assistant 1340 Charles St Ste 100, Rockford, IL 61104 2015-10-29
1770846974 Krystle N Lange Surgery 1340 Charles St Ste 100, Rockford, IL 61104-2200 2012-06-21
1679851984 Mathew Tod Legel Orthopaedic Surgery 1340 Charles St Ste 100, Rockford, IL 61104-2200 2011-08-03
1518253640 Lacey M Stelle Surgery 1340 Charles St Ste 100, Rockford, IL 61104-2200 2011-06-27
1366612012 Jason J Klovning Surgery 1340 Charles St Ste 100, Rockford, IL 61104-2200 2008-03-10

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1699216564 Swedishamerican Hospital Nutritionist 1415 E. State St., Lower Level A3, Rockford, IL 61104 2017-03-13
1376950485 Swedishamerican Hospital Nurse Practitioner 1340 Charles St Ste 200, Rockford, IL 61104 2014-07-21
1871907774 Oday Alsarraf Psychiatry & Neurology 1401 E State Street, Center for Mental Health, Swedish American Hospital, Rockford, IL 61104 2014-06-18
1962652339 Children's Home and Aid Community/Behavioral Health 424 7th St, Rockford, IL 61104 2008-09-23
1790873016 David J Schleicher Obstetrics & Gynecology 209 9th St Ste 200, Rockford, IL 61104 2006-10-11
1013026624 Thomas Ryan Moss Dentist 1415 E State Street, Rockford, IL 61104 2006-08-29
1366452096 Arturo Santiago Manas Obstetrics & Gynecology 1415 E State St Fl 8, Rockford, IL 61104 2006-08-08
1245263268 William John Stout Physician Assistant 1401 E State Street, Rockford, IL 61104 2006-07-10
1689604969 Prabha Chand Dosi Pediatrics 1401 E. State Street, Rockford, IL 61104 2006-07-03
1962457499 Lynn Mary Kutsche Pediatrics 1415 E State St, Suite 601, Rockford, IL 61104 2006-05-23
Find all providers in zip 61104

Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1871063776 Amira Al-basha Physician Assistant 1639 N Alpine Rd Ste 380, Rockford, IL 61107-1440 2018-12-04
1578042982 Alyssa Margaret Vasylyuk Physician Assistant 2350 N Rockton Ave Fl 4, Rockford, IL 61103-3600 2018-08-08
1053778456 Jamie Anticevich Physician Assistant 6595 East State Street, Rockford, IL 61108-2542 2016-01-15
1437534666 Irene Dyer Physician Assistant 1560 Red Oak Ln, Rockford, IL 61107-2767 2015-07-29
1215250675 Krista R Mohamed Physician Assistant 1401 E. State St., Swedish American Hospital, Rockford, IL 61104-2315 2010-03-12
1629121009 Jason A. Kadar Physician Assistant 2902 Mcfarland Rd Ste 300, Rockford, IL 61107-6801 2007-01-19
1295805851 Kristin Lynn King-shank Physician Assistant 171 Dogwood Dr Ne, Rockford, MI 49341-7361 2006-11-09
1245263268 William John Stout Physician Assistant 1401 E State Street, Rockford, IL 61104 2006-07-10
1952356040 Saint Anthony Medical Center Physician Assistant 6830 Villagreen Vw, Rockford, IL 61107-5639 2006-05-24
1972552131 Andrea B Fulcomer Physician Assistant 2404 Charles St, Rockford, IL 61108-1602 2006-05-08
Find all providers in ROCKFORD

Competitor

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City ROCKFORD
Zip Code 61104

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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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