Active NPI 1376640474 Individual Practitioner Male Practitioner

Dr. Pothen Jacob , MD

Pediatrics • E St Louis, IL

Professional Overview & Biography Verified Profile Summary

Dr. Pothen Jacob, MD is a registered healthcare professional specializing in Pediatrics in E St Louis, IL. Practice services are available at 4601 STATE ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4601 State St
Suite #210

E St Louis, IL 622051359

Telephone 6188743700

Fax 6188745031

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in E St Louis, IL

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 21.7 Yrs

Regional Practice Density

1 Specialists

Practicing in E St Louis, IL (3277 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License IL 3648725

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location July 08, 2007

Registered at 4601 STATE ST, SUITE #210, E ST LOUIS, IL 622051359 (Tel: 6188743700)

📍

Updated Business Mailing Address July 08, 2007

Registered at PO BOX 2228, 4601 STATE ST SUITE #210, E ST LOUIS, IL 622051359 (Tel: 6188743700)

👤

Provider Name / Credentials Updated July 08, 2007

Recorded as POTHEN JACOB, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Pediatrics (License #3648725 in IL)

🟢

Initial NPI Registration & Enumeration September 20, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1376640474

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: September 20, 2006

Last Update: July 08, 2007

Sole Proprietor: No

Update or Correct Profile

Mailing Address

Po Box 2228, 4601 State St Suite #210

E St Louis, IL 622051359

Phone: 6188743700

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.