Individual provider Active NPI

Lisa Chico, LCSW

  • Clinical Social Worker
  • Hoffman Estates, IL
National Provider Identifier
1417366394
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1786 Moon Lake Blvd
Hoffman Estates, IL 60169-5029
Phone
(847) 755-8090
NPI assigned
Aug 5, 2014
Last updated
Sep 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NONE
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

1786 Moon Lake Blvd
Hoffman Estates, IL 60169-5029

Mailing address

1786 Moon Lake Blvd
Hoffman Estates, IL 60169-5029
Phone (847) 755-8090

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
I20171208000048 IL Practitioner - Clinical Social Worker 1254698798 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1650 Moon Lake Blvd
Hoffman Estates, IL 60169-1010
Phone (847) 755-8090

1786 Moon Lake Blvd
Suite 104
Hoffman Estates, IL 60169-1016
Phone (847) 755-8090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rosecrance Inc Current Accepting new patients
Lisa Chico Couseling Services, LLC Clinical Current Accepting new patients
Rosecrance Inc CurrentSince Nov 13, 2017 Accepting new patients
Rosecrance, Inc. CurrentSince Nov 13, 2017 Accepting new patients
Alexian Brothers Behavioral Health Hospital Mental Health CurrentSince Oct 3, 2022 Accepting new patients

Locations

1650 Moon Lake Blvd
Hoffman Estates, IL 60169
Phone (800) 432-5005

1786 Moon Lake Blvd
Hoffman Estates, IL 60169
Phone (847) 640-5640

1021 N Mulford Rd
Rockford, IL 61107
Phone (815) 387-5600

1601 University Dr
Rockford, IL 61107
Phone (815) 387-2500

Interoperability endpoints

  • Direct secure messaging: lisa.chico.1@15182.direct.athenahealth.com
  • Direct secure messaging: lisa.chico.1@380.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1407196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1417366394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1786 MOON LAKE BLVD",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601695029",
            "telephone_number": "847-755-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1786 MOON LAKE BLVD",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601695029",
            "telephone_number": "847-755-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHICO",
        "first_name": "LISA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-05",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "NONE",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoffman Estates, IL

Sources for this page

Verify at the official NPI Registry.