Individual provider Active NPI

Lauren Victoria Rasawehr, PA-C

  • Family Medicine Physician
  • Evergreen Park, IL
National Provider Identifier
1063125771
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
085009456 Issued in IL
Practice address
2850 W 95TH St Ste 101
Evergreen Park, IL 60805-2703
Phone
(708) 499-2070
NPI assigned
Dec 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 085009456 IL Primary

Addresses

Primary practice location

2850 W 95TH St Ste 101
Evergreen Park, IL 60805-2703

Mailing address

2850 W 95TH St Ste 101
Evergreen Park, IL 60805-2703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230328000217 IL Practitioner - Physician Assistant 6507230828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

2850 W 95TH St
Evergreen Park, IL 60805-2703

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

  • Osf Home Health Home health agency, Oak Lawn, IL, CCN 147404
  • Osf Little Company of Mary Medical Center Hospital, Evergreen Park, IL, CCN 140179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085009456ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Mar 15, 2023 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

2850 W 95th St
Ste 101
Evergreen Pk, IL 60805
Phone (708) 425-9550

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1672185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1063125771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 W 95TH ST STE 101",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 W 95TH ST STE 101",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052703",
            "telephone_number": "708-499-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASAWEHR",
        "first_name": "LAUREN",
        "middle_name": "VICTORIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-28",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "085009456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evergreen Park, IL

Sources for this page

Verify at the official NPI Registry.