Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Alisha Jacob, FNP-C

Individual provider Registered Nurse · NPI 1356151492

Alisha Jacob, FNP-C is a Nurse Practitioner in Libertyville, Illinois. Qualified in 2024, 2 years ago. Practices with Southerncare, Inc, a 9-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
2
Licensed in
IL
In the registry since
2025
Specialties on file
2
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

801 S Milwaukee Ave
Libertyville, IL 60048-3204
Phone: (847) 990-5173
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 515 W Caldwell Dr, Round Lake, IL 60073-4296 — (847) 630-1671

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 209-031813 (IL)
Registered Nurse Taxonomy 163W00000X · Licence 041482764 (IL)

Record details

NPI number1356151492
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-C
Sole proprietorYes
NPI enumeratedJanuary 10, 2025
Last updated in NPPESFebruary 5, 2026
Certification dateFebruary 5, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Southerncare, Inc. — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Libertyville