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

Jacob Matthew Smith

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1760838965

Jacob Matthew Smith is a Family Practice in Chicago, Illinois. Graduated from Rush Medical College of Rush University in 2016, 10 years ago. Practices with Pcc Community Wellness Center, a 89-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
10
Trained at
Rush Medical College of Rush University
Licensed in
IL
In the registry since
2016
Specialties on file
2
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Practice location Address checks out

1044 N Mozart St Ste 100
Chicago, IL 60622-3644
Phone: (773) 292-8300
Fax: (773) 292-2601
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2750 W North Ave, Chicago, IL 60647-5247 — (312) 666-3494

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 036149766 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1760838965
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 6, 2016
Last updated in NPPESDecember 27, 2019
Certification dateDecember 27, 2019
Mailing address1044 N Mozart St Ste 100, Chicago, IL 60622-3644

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolRUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
Graduated 2016 (10 years in practice)
Group practice Pcc Community Wellness Center — 89 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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