Jacob D Rudolph, MD is a
Student In An Organized Health Care Education/training Program physician based in Chicago, Illinois. Jacob D Rudolph is licensed to practice in Illinois (license number ) and his current practice location is 1740 W Taylor St, Chicago, Illinois. He can be reached at his office (for appointments etc.) via phone at
(312) 996-2933.
NPI number for Jacob D Rudolph is 1306696737 and his current mailing address is 820 S Wood St Ste 100, Chicago, Illinois. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1306696737.
Physician's Profile
| Full Name | Jacob D Rudolph |
|---|
| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 1740 W Taylor St, Chicago, Illinois |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1306696737
- Provider Enumeration Date: 03/26/2024
- Last Update Date: 03/26/2024
Medical Identifiers
Medical identifiers for Jacob D Rudolph such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1306696737 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | 1306696737 (Illinois) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jacob D Rudolph is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jacob D Rudolph, MD
820 S Wood St Ste 100,
Chicago, IL 60612-4325
Ph: (312) 996-2933 | Jacob D Rudolph, MD
1740 W Taylor St,
Chicago, IL 60612-7232
Ph: (312) 996-2933 |
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