MEDICARE: RACHEL H JACOBS PHD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TB0200X	Cognitive & Behavioral Psychologist

General Provider Information

NPI Number	:	1275203242
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RACHEL H JACOBS PHD PC

Provider Business Mailing Address
First Line	:	561 W DIVERSEY PKWY STE 209
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-1682
Country	:	US
Telephone Number	:	773-830-4725
Fax Number	:

Provider Business Practice Location Address
First Line	:	561 W DIVERSEY PKWY STE 209
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-1682
Country	:	US
Telephone Number	:	773-830-4725
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL PSYCHOLOGIST
Name	:	RACHEL H JACOBS
Credential	:	PHD
Telephone Number	:	773-830-4725

Provider Enumeration Date	:	09/20/2021
Last Update Date	:	12/10/2025

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