Individual provider Active NPI

Ruth Mellenthin, LCSW

  • Clinical Social Worker
  • Mount Prospect, IL
National Provider Identifier
1104206655
Registry record updated Jul 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-018650 Issued in IL
Practice address
1803 W Willow LN
Mt Prospect, IL 60056-4412
Phone
(312) 810-2601
NPI assigned
May 30, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149-018650 IL Primary
Social Worker 104100000X 150-013328 IL

Addresses

Primary practice location

1803 W Willow LN
Mt Prospect, IL 60056-4412

Mailing address

1803 W Willow LN
Mt Prospect, IL 60056-4412
Phone (312) 810-2601

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160907001095 IL Practitioner - Clinical Social Worker 6800182536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2006
Medicare assignment
May accept Medicare assignment
Group practices
Rodasi LLCGroup PAC ID 0749418630, 34 clinicians

Practice addresses (Care Compare)

2500 W Higgins Rd
Suite 105
Hoffman Estates, IL 60169-2040
Phone (888) 870-1775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
150-013328ILMDSocial Worker
149-018650ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rodasi LLC Clinical CurrentSince Jan 7, 2020 Accepting new patients

Locations

3166 N Lincoln Ave
Ste 401
Chicago, IL 60657
Phone (630) 473-3091

2500 W Higgins Rd
Ste 105
Hoffman Estates, IL 60169
Phone (773) 904-0094

684 S Barrington Rd
Streamwood, IL 60107
Phone (630) 883-0815

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1432944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1104206655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 W WILLOW LN",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600564412",
            "telephone_number": "312-810-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 W WILLOW LN",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600564412",
            "telephone_number": "312-810-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLENTHIN",
        "first_name": "RUTH",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-30",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-018650",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150-013328",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Prospect, IL

Sources for this page

Verify at the official NPI Registry.