Individual provider Active NPI

Ellie Routtenberg, LCSW

  • Clinical Social Worker
  • Evanston, IL
National Provider Identifier
1184849945
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149003011 Issued in IL
Practice address
425 Davis St Unit 309
Evanston, IL 60201-4767
Phone
(847) 814-7328
Fax
(847) 814-7328
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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 149003011 IL Primary

Addresses

Primary practice location

425 Davis St Unit 309
Evanston, IL 60201-4767

Mailing address

425 Davis St Unit 309
Evanston, IL 60201-4767
Phone (847) 814-7328

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
I20051021000100 IL Practitioner - Clinical Social Worker 7719903442 Reassigns benefits to 1 organization
Practice locations: Evanston, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

425 Davis St
Unit 309
Evanston, IL 60201-4767
Phone (847) 814-7328

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Journeycare, Inc Current Accepting new patients
Journeycare, Inc. CurrentSince Oct 1, 2015 Accepting new patients

Locations

2050 Claire Ct
Glenview, IL 60025
Phone (847) 467-7425

405 Lake Zurich Rd
North Barrington, IL 60010
Phone (847) 381-5599

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.

NPI Registry JSON

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1184849945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 DAVIS ST UNIT 309",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014767",
            "telephone_number": "847-814-7328",
            "fax_number": "847-814-7328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 DAVIS ST UNIT 309",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014767",
            "telephone_number": "847-814-7328",
            "fax_number": "847-814-7328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUTTENBERG",
        "first_name": "ELLIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149003011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.