DR. CAROLYN JACOB MD
NPI 1265498083
Dermatology in Chicago, IL

Q: What is Carolyn Jacob's NPI number?

The NPI number for Carolyn Jacob is 1265498083. It was assigned to this individual provider in the NPPES registry on April 21, 2006.

Q: What is Carolyn Jacob's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Q: When was this NPI record last updated?

The NPPES record for Carolyn Jacob was last updated on February 5, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 21, 2006PECOS EnrolledAccepts Medicare Assignment

515 N STATE ST STE 900, CHICAGO, IL 60654(312) 245-9965(312) 245-9964 Get Directions Write a Review

NPPES record last updated: February 5, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Feb 5, 2020, Sep 12, 2019 (2 updates tracked since 2019).

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About Dr. Carolyn Jacob Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. CAROLYN JACOB MD (NPI 1265498083) is an individual dermatology provider in Chicago, Illinois, licensed in Illinois (036102098) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS and is a graduate of University College Of Medicine (1995).

NPPES Registry Identity

NPI1265498083

Entity TypeIndividualFemale

Primary Taxonomy207N00000X

Provider Legal NameDR. CAROLYN JACOBCredential: MD

Location Address515 N STATE ST STE 900Chicago, IL 60654

Mailing Address515 N State St Ste 900Chicago, IL 60654-9104 · (312) 245-9965 · Fax (312) 245-9964

Phone(312) 245-9965

Fax(312) 245-9964

Sole ProprietorNo

Medical School CMSUniversity College Of MedicineGraduated 1995

Enumeration DateApril 21, 2006

Last NPPES UpdateFebruary 5, 20202 updates tracked since enumeration

✔ NPI 1265498083 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

License✔ Licensed in IL · 036102098

Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X · License 036102098 (IL)

515 N STATE ST STE 900, Chicago, IL 60654

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Other Identifiers 1

Medicaid036102098IL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Carolyn Jacob Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3678530409

PECOS Enrollment IDI20041215000359

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Carolyn Jacob reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Chicago Cosmetic Surgery And Dermatology Sc

0.1 mi

Dermatology

515 N STATE ST STE 900
Chicago, IL 60654

Reassigned Medicare billing, Illinois enrollment
5 clinicians in this Medicare group

NPI 1407068000 (312) 245-9965

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

80 services62 patients

Destruction of precancer skin growth, 2-14 growths 17003

This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.

67 services17 patients

Destruction of precancer skin growth, 1 growth 17000

"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.

41 services28 patients

Destruction of skin growth, 1-14 growths 17110

"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.

38 services29 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

23 services22 patients

Biopsy of related skin growth, first growth 11102

A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.

19 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60654 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.06 typical visit price

range $60.08 – $183.39

Typical copayment $23.51 (range $15.02 – $45.84)

Most-billed visit code 99203

Established Patient

$74.80 typical visit price

range $18.97 – $148.12

Typical copayment $18.70 (range $4.74 – $37.03)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAROLINE SHEPPARD PA-C

Physician Assistant