Lisa Raubolt

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149015331 Issued in IL

Practice address

676 N Saint Clair St
Chicago, IL 60611-2927

Phone

(312) 926-4512

NPI assigned

Sep 20, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Edgewood Clinical Services P.C.Group PAC ID 3971963901, 304 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
• devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
• devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
• IL HMO C-SNP
• IL PPO Downstate

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Edgewood Clinical Services, P.C.

  • Psychologist
  • Naperville, IL
  • NPI 1295914646

  Clinical

  Medicare reassignment Care Compare group NPD
• Psychology Specialists LTD

  • Clinical Psychologist
  • Bloomington, IL
  • NPI 1053368605
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422835200000",
    "number": "1003242124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112927",
            "telephone_number": "312-926-4512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112927",
            "telephone_number": "312-926-4512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAUBOLT",
        "first_name": "LISA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-20",
        "last_updated": "2015-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149015331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie B Ratz, MS, RD, CNSC
• Jaclyn Lee Rau, PHARMD
• Jason D Rauba, M.D.
• Kendra Rauber, D.O.
• Garrett Raubolt, MSW, LCSW
• Janice Raucci
• Gregory S. Rauch, M.D.
• Jessica Hannah Rauch
• Ryan Rauch
• Sydney Lee Raucher

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.