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

Justin Jacobson, PA

Individual provider Physician Assistant · NPI 1528478104

Justin Jacobson, PA is a Physician Assistant in Rockford, Illinois. Qualified in 2014, 12 years ago. Practices with Swedishamerican Hospital, a 387-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
12
Licensed in
IL
In the registry since
2014
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1340 Charles St Ste 100
Rockford, IL 61104
Phone: (779) 696-1900
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085-005085 (IL)

Record details

NPI number1528478104
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 5, 2014
Last updated in NPPESFebruary 19, 2021
Certification dateFebruary 19, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Swedishamerican Hospital — 387 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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