Individual provider Active NPI

Rachel Ondersma, LCSW

  • Clinical Social Worker
  • Evanston, IL
National Provider Identifier
1154587178
Registry record updated Jul 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.013040 Issued in IL
Practice address
600 Davis St
Evanston, IL 60201-4488
Phone
(734) 645-9252
NPI assigned
Jul 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.013040 IL Primary

Addresses

Primary practice location

600 Davis St
Evanston, IL 60201-4488

Mailing address

3650 N Oakley Ave
Floor 2
Chicago, IL 60618-4811
Phone (734) 645-0252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.013040ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217289600000",
    "number": "1154587178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 N OAKLEY AVE",
            "address_2": "FLOOR 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606184811",
            "telephone_number": "734-645-0252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 DAVIS ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014488",
            "telephone_number": "734-645-9252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONDERSMA",
        "first_name": "RACHEL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-29",
        "last_updated": "2008-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.013040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.