- Practice location
- 1340 Charles St Ste 401, Rockford, IL 61104-2200
- Phone
- 779-696-6102
- Fax
- —
- Last updated
- December 27, 2024
Mark Kevin Jacob is an Internal Medicine, Pulmonary Disease based in Rockford, IL. Mark Kevin Jacob practices in Rockford, IL and has the professional credentials of MD. The NPI Number for Mark Kevin Jacob is 1063688497 and holds a License No. 4301086585 (MI). The current practice location address for Mark Kevin Jacob is 1340 Charles St Ste 401, Rockford, IL 61104-2200 and can be reached out via phone at 779-696-6102.
Provider Profile Details
- NPI Number
- 1063688497
- Provider Name
- Mark Kevin Jacob
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 1340 Charles St Ste 401, Rockford, IL 61104-2200
- Phone Number
- 779-696-6102
- Primary Taxonomy
- Internal Medicine, Pulmonary Disease · 207RP1001X
- Sole Proprietor
- No
- Provider Enumeration Date
- May 6, 2008
- Last Update Date
- December 27, 2024
- Certification Date
- December 27, 2024
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1340 Charles St Ste 401
Rockford, IL 61104-2200 - City
- Rockford
- State
- Illinois
- Zip
- 61104-2200
- Phone Number
- 779-696-6102
Provider Business Mailing Address Details
- Address
- 160 Allen St
Medical Staff Office
Rutland, VT 05701-4560 - City
- Rutland
- State
- VT
- Zip
- 05701-4560
- Phone Number
- 913-909-7400
License Information
- License Number (1)
- 4301086585
- License State (1)
- MI
- Taxonomy (1)
- Internal Medicine · 207R00000X
- License Number (2)
- 036.161882
- License State (2)
- IL
- Taxonomy (2)
- Internal Medicine, Critical Care Medicine · 207RC0200X
- License Number (3)
- 04-331614
- License State (3)
- KS
- Taxonomy (3)
- Internal Medicine, Critical Care Medicine · 207RC0200X
- License Number (4)
- 04-331614
- License State (4)
- KS
- Taxonomy (4)
- Internal Medicine, Pulmonary Disease · 207RP1001X
- License Number (5)
- 2011-01117
- License State (5)
- NC
- Taxonomy (5)
- Internal Medicine, Pulmonary Disease · 207RP1001X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Internal Medicine, Pulmonary Disease providers near Rockford, IL
View all Internal Medicine, Pulmonary Disease providers in Rockford →- Abu F Abbasi, MDInternal Medicine · NPI 1083243877
- Sanaiya Ahmed, MDStudent in an Organized Health Care Education/Training Program · NPI 1285574558
- Moamen M Al Zoubi, MDInternal Medicine, Infectious Disease · NPI 1770902587
- Kevin Adams, OTROccupational Therapist · NPI 1043109192
- Carlos Aguero-Medina, MDFamily Medicine · NPI 1053364349
- Stephen N Ackah, FNP-BCNurse Practitioner · NPI 1619724424
Frequently Asked Questions
What is the NPI number of Dr. Mark K Jacob, MD?
The NPI number of Dr. Mark K Jacob, MD is 1063688497. It was assigned on May 6, 2008 and is currently active in the NPPES registry.
What is the specialty of Dr. Mark K Jacob, MD?
Dr. Mark K Jacob, MD is registered under the primary taxonomy Internal Medicine, Pulmonary Disease (code 207RP1001X), licensed in MI under license number 4301086585.
Where does Dr. Mark K Jacob, MD practice?
The practice location is 1340 Charles St Ste 401, Rockford, IL 61104-2200. The office can be reached at 779-696-6102 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1063688497 directly on the NPPES registry website.