Rockland Professional Group LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

ROCKLAND PROFESSIONAL GROUP LLC

Practice address

114 W Rockland Rd
Libertyville, IL 60048-2774

Phone

(847) 816-9180

Fax

(847) 816-9183

NPI assigned

Dec 15, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Brett A Sisler, LCSWNPI 1609090844

Title

Owner Administrator

Phone

(847) 816-9180

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brett Alan Sisler, LCSW LICENSED CLINIC

  • Clinical Social Worker
  • Libertyville, IL
  • NPI 1609090844
  Medicare reassignment NPD Authorized official
• Elisabeth A. V. Desapereira, MD

  • Psychiatry Physician
  • Libertyville, IL
  • NPI 1134196678
  NPD (past)
• Jennifer Wagner, LCSW

  • Clinical Social Worker
  • Libertyville, IL
  • NPI 1881050607
  NPD (past)

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196121600000",
    "number": "1295897148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 W ROCKLAND RD",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482774",
            "telephone_number": "847-816-9180",
            "fax_number": "847-816-9183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 W ROCKLAND RD",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600482774",
            "telephone_number": "847-816-9180",
            "fax_number": "847-816-9183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKLAND PROFESSIONAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2007-11-27",
        "status": "A",
        "authorized_official_last_name": "SISLER",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER ADMINISTRATOR",
        "authorized_official_telephone_number": "847-816-9180",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "04920480",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alia Miriam Roberts, MD
• Jessica Diane Roberts, FNP-BC
• Monica Lee Roberts, L.C.P.C
• Katherine M Robinson, CCC-SLP
• Mark Eric Robson, ATC
• Lynda Roden, DOSC
• Ellen Rodman-Stone, LCPC
• Aimee Rodolff, PSY.D., LCP, APIT
• Isamar Rodriguez, DPT
• Lisa M Rodriguez, APRN

• Mental Health Clinic/Center (Including Community Mental Health Center) in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.