DR. EUNICE SAJAN JACOB-CHARLY (NPI# 1689105413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689105413 |
| Entity Type | Individual |
| Full Name | DR. EUNICE SAJAN JACOB-CHARLY |
| Other Name | DR. EUNICE SAJAN JACOB |
| Credential | DO |
| Practice Address |
1200 W State St Rockford IL 61102-2112 |
| Practice Telephone | 8154901600 |
| Practice Fax Number | 8154901881 |
| Mailing Telephone | 8154901600 |
| Mailing Fax Number | 8154901600 |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2020-08-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 036.151197 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
1200 W STATE ST |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61102-2112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780680827 | Barbara B Morgan | Nurse Practitioner | 1200 W State St, Rockford, IL 61102-2112 | 2005-06-23 |
| 1588271894 | Angela Siebold | Nurse Practitioner | 1200 W State St, Rockford, IL 61102-2112 | 2020-09-30 |
| 1942814322 | Jacqueline Paige Cabrera | Nurse Practitioner | 1200 W State St, Rockford, IL 61102-2112 | 2020-09-03 |
| 1285250951 | Aaleeyah Pringle Alim | Dentist | 1200 W State St, Rockford, IL 61102-2112 | 2020-06-18 |
| 1639792419 | Jessica Lauren Cole | Physician Assistant | 1200 W State St, Rockford, IL 61102-2112 | 2020-05-27 |
| 1437779071 | Christian Murillo | Physician Assistant | 1200 W State St, Rockford, IL 61102-2112 | 2020-04-23 |
| 1033746573 | Erin Ashleigh Donahue | Physician Assistant | 1200 W State St, Rockford, IL 61102-2112 | 2020-03-25 |
| 1609406008 | Marissa Dreger | Family Medicine | 1200 W State St, Rockford, IL 61102-2112 | 2020-01-24 |
| 1962041657 | Sabrina Lee Puvalowski | Physician Assistant | 1200 W State St, Rockford, IL 61102-2112 | 2019-12-30 |
| 1932741717 | Jacob Dalton Boehm | Physician Assistant | 1200 W State St, Rockford, IL 61102-2112 | 2019-10-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205115383 | Renee Lynn Keeney | Advanced Practice Midwife | 1200 W. State Street, Crusader Community Health, Rockford, IL 61102 | 2011-08-08 |
| 1689895906 | Linda Lou O'reilly | Local Education Agency (LEA) | 1515 S. Meridian Road, Rockford, IL 61102 | 2007-05-02 |
| 1801012992 | Jennifer Anne Boyd | Developmental Therapist | Nia 1515 S. Meridian Rd., Rockford, IL 61102 | 2007-04-17 |
| 1609173434 | Kellie J Gibbons | Registered Nurse | 650 W State Street, Winnebago County Jail Medical Unit, Rockford, IL 61102-0000 | 2011-02-14 |
| 1275708752 | Mercy Ambulance Service LLC | Ambulance | 1025 Campton Dr, Rockford, IL 61102-1066 | 2008-04-25 |
| 1417448424 | Brittany Nicole Lambert | Student in an Organized Health Care Education/Training Program | 8040 Towermont Dr, Rockford, IL 61102-1080 | 2018-05-24 |
| 1164490132 | Harlan Johnson | Counselor | 852 Lakewood Dr, Rockford, IL 61102-1228 | 2006-03-08 |
| 1184137283 | Gail Mary Swenson | Speech-Language Pathologist | 730 Lincoln Park Blvd, Rockford, IL 61102-1429 | 2017-11-10 |
| 1659316339 | Institute of Family Care | Home Health | 417 S Pierpont Ave, Rockford, IL 61102-1656 | 2006-06-18 |
| 1861851438 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1200 W State St Ste 102, Rockford, IL 61102-2112 | 2016-02-11 |
| Find all providers in zip 61102 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962002832 | Coleman Clinic, Inc. | Internal Medicine | 1893 Daimler Rd Ste A, Rockford, IL 61112-1081 | 2020-10-29 |
| 1073167664 | Swedishamerican Hospital | Internal Medicine | 3505 N Bell School Road, Rockford, IL 61114 | 2019-07-31 |
| 1376077453 | Spectrum Health Primary Care Partners | Internal Medicine | 8501 Meadowcreek Dr, Rockford, MI 49341 | 2017-04-17 |
| 1871838656 | Takuo Sonoda | Internal Medicine | 729 Self Hollow Rd, Rockford, TN 37853-3413 | 2012-12-04 |
| 1912216284 | Irene Boswell Md PC | Internal Medicine | 7445 Newburg Rd, Suite 103, Rockford, IL 61108-4443 | 2010-10-04 |
| 1326271743 | Syed Muhammad Murtaza Zam Rizvi | Internal Medicine | 1340 Charles St Ste 405, Rockford, IL 61104-2200 | 2009-09-02 |
| 1679714216 | John Martin Roska | Internal Medicine | 1711 Shaw Woods Dr., Rockford, IL 61107-1725 | 2009-03-11 |
| 1457515280 | Carl Gerald Sundahl | Internal Medicine | 4519 Old Knoxville Hwy, Rockford, TN 37853-3023 | 2008-07-10 |
| 1497845135 | Humaira Bari | Internal Medicine | 2400 N. Rockton Avenue, Rockford, IL 61103 | 2006-10-13 |
| 1629176060 | Christine Judith Simaytis | Internal Medicine | 4940 E State St Ste 3, Rockford, IL 61108-2271 | 2006-09-20 |
| Find all providers in ROCKFORD | ||||
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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.