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MARK B JACOB
NPI 1659486751
Oral & Maxillofacial Surgery in Highland Park, IL

Active since August 20, 2006Opted out of Medicare · through Apr 1, 2027
1893 SHERIDAN RD STE 311, HIGHLAND PARK, IL 60035(847) 433-6636(847) 433-2090 Get Directions Write a Review

NPPES record last updated: December 28, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mark B Jacob NPPES

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

MARK B JACOB (NPI 1659486751) is an individual oral & maxillofacial surgery provider in Highland Park, Illinois, licensed in Illinois (021.002059) and active in the NPI registry since August 2006. He has opted out of Medicare through April 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1659486751
Entity TypeIndividualMale
Primary Taxonomy204E00000X
Provider Legal NameMARK B JACOB
Location Address1893 SHERIDAN RD STE 311Highland Park, IL 60035-2646
Mailing Address809 S Marshfield Ave, 9th Floor (m/c 732)Chicago, IL 60612-4305 · (312) 996-7699 · Fax (312) 996-1001
Phone(847) 433-6636
Fax(847) 433-2090
Sole ProprietorNo
Enumeration DateAugust 20, 2006
Last NPPES UpdateDecember 28, 2023
NPPES CertifiedDecember 28, 2023
✔ NPI 1659486751 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
License✔ Licensed in IL · 021.002059
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
1893 SHERIDAN RD STE 311, Highland Park, IL 60035
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Mark B Jacob has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2011 through April 1, 2027.

Opt-Out Effective DateApril 1, 2011
Opt-Out In Effect ThroughApril 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Jacob's NPI number?

The NPI number for Mark Jacob is 1659486751. It was assigned to this individual provider in the NPPES registry on August 20, 2006.

Where is Mark Jacob located?

Mark Jacob practices at 1893 Sheridan Rd Ste 311, Highland Park, IL 60035. The listed phone number is (847) 433-6636.

What is Mark Jacob's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Mark Jacob enrolled in Medicare?

No. Mark Jacob has opted out of Medicare through April 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Mark Jacob accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 5 other insurers list Mark Jacob as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mark Jacob was last updated on December 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.