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

Jacob Manoj Kitchener, MD

Individual provider Vascular Neurology Physician · NPI 1003818733

Jacob Manoj Kitchener, MD is an Interventional Radiology in Springfield, Illinois. Graduated from Northeastern Ohio University College of Medicine in 2000, 26 years ago. Practices with SSM Health Care Group, a 923-clinician group, works from 5 locations and accepts Medicare assignment. Licensed in Illinois, Missouri and Ohio.

Years since qualifying
26
Trained at
Northeastern Ohio University College of Medicine
Licensed in
IL, MO, OH
In the registry since
2005
Specialties on file
5
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

421 N 9th St
Springfield, IL 62702
Phone: (217) 757-6868
Fax: (177) 576-8672
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 3 Saint Elizabeth Blvd, O Fallon, IL 62269-1281 — (618) 641-5803
  • 301 N 8th St, Springfield, IL 62701-1041 — (217) 528-7541
  • One Hospital Dr, Columbia, MO 65212-0001 — (573) 882-1515
  • 30 E Apple St Ste 5254a, Dayton, OH 45409-2939 — (937) 208-4200

Specialties & licences

Vascular Neurology Physician (primary) Taxonomy 2084V0102X · Licence 036111221 (IL)
Vascular Neurology Physician Taxonomy 2084V0102X · Licence 35.086697 (OH)
Neurology Physician Taxonomy 2084N0400X · Licence 2009027338 (MO)
Neurology Physician Taxonomy 2084N0400X · Licence 036111221 (IL)
Clinical Neurophysiology Physician Taxonomy 2084N0600X · Licence 35-08-6697-K (OH)

Record details

NPI number1003818733
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 12, 2005
Last updated in NPPESApril 28, 2026
Certification dateApril 28, 2026
Mailing address421 N 9th St, Springfield, IL 62702-5317

Medicare enrollment

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

Medicare specialtyINTERVENTIONAL RADIOLOGY
Also practisesNEUROLOGY
Medical schoolNORTHEASTERN OHIO UNIVERSITY COLLEGE OF MEDICINE
Graduated 2000 (26 years in practice)
Group practice Ssm Health Care Group — 923 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare