MR. SHANE SAJI JACOB (NPI# 1609484468) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609484468 |
| Entity Type | Individual |
| Full Name | MR. SHANE SAJI JACOB |
| Credential | PA |
| Practice Address |
18w194 Claremont Dr Darien IL 60561-3640 |
| Mailing Address |
5707 S Cass Ave Westmont IL 60559-4800 |
| Practice Telephone | 6305060983 |
| Mailing Telephone | 0000000000 |
| Enumeration Date | 2020-07-17 |
| Last Update Date | 2020-08-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
18W194 CLAREMONT DR |
| City | DARIEN |
| State | IL |
| Zip Code | 60561-3640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801413190 | Rachel Lynn Boehmert | Behavioral Analyst | 8149 South Cass Avenue, Darien, IL 60561 | 2020-07-02 |
| 1033571096 | Jeanette Marinier | Physician Assistant | 7421 Cass Ave, Darien, IL 60561 | 2016-03-28 |
| 1154750024 | Chicago Sciences Medical Corporation | Internal Medicine | 8348 Lemont Road, Darien, IL 60561 | 2013-11-01 |
| 1598053761 | Illinois Injury & Rehab Centers, Ltd | Chiropractor | 2841 83rd Court, Suite 109, Darien, IL 60561 | 2011-07-21 |
| 1699064824 | Valerie Laniosz | Dermatology | 8110 S Cass Avenue, Darien, IL 60561 | 2011-03-28 |
| 1619290921 | Caring Partners Health Care, Inc. | Home Health | 17 W 674 Concord Place, Darien, IL 60561 | 2010-03-02 |
| 1669689584 | Julie R Marshall | Registered Nurse | 6636 Ridge Road, Darien, IL 60561 | 2007-05-17 |
| 1083737993 | Cheryl Faith Daley | Developmental Therapist | 121 67th St, Darien, IL 60561 | 2007-04-06 |
| 1619072550 | Research Design Inc | Durable Medical Equipment & Medical Supplies | 8177 S Cass Ave, Darien, IL 60561 | 2006-09-14 |
| 1467556530 | Suzanne Klucher Kasang | Dentist | 805 Plainfield Road, Suite 212, Darien, IL 60561 | 2006-09-11 |
| Find all providers in zip 60561 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245855543 | Lina Starovoitova | Physician Assistant | 22 Wakemore St, Darien, CT 06820-2411 | 2020-06-11 |
| 1033571096 | Jeanette Marinier | Physician Assistant | 7421 Cass Ave, Darien, IL 60561 | 2016-03-28 |
| 1780053983 | Keri Plica | Physician Assistant | 722 69th St, Darien, IL 60561-3825 | 2015-09-17 |
| 1891886156 | Christina Martineau | Physician Assistant | 23 Old Stone Rd, Darien, CT 06820-4419 | 2006-09-28 |
| 1922518513 | Erin Elizabeth Browne | Physician Assistant | 8190 Cass Ave, Darien, IL 60561-5013 | 2017-10-09 |
| 1265833578 | Wei Wei | Physician Assistant | 8190 S Cass Ave, Darien, IL 60561-5013 | 2014-09-07 |
| 1174946750 | Melissa Pulcini-buttine | Physician Assistant | 106 Noroton Ave, Darien, CT 06820-5237 | 2014-02-02 |
| 1922287614 | Karen A Smith | Physician Assistant | 8110 S Cass Ave, Darien, IL 60561-5013 | 2007-10-30 |
| 1396946158 | Robert James Lucas | Physician Assistant | 17 Old Kings Highway South, A & M Surgery, Darien, CT 06820 | 2007-05-30 |
| 1023136512 | Susan Kay Boland | Physician Assistant | 300 North Washington Street, Darien Medical Clinic, Darien, WI 53114-1534 | 2007-03-26 |
| Find all providers in DARIEN | ||||
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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.