Lisa Raciak, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

150015479 Issued in IL

Practice address

2081 Calistoga Dr
Suite #2S
New Lenox, IL 60451-4831

Phone

(888) 736-3611

NPI assigned

Jul 8, 2016

Last updated

Jul 8, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rockford Psychiatric Medical Services SCGroup PAC ID 6901089515, 154 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lisa.raciak.2@25899.direct.athenahealth.com

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.

• Rockford Psychiatric Medical Services, S.C.

  • Psychiatry Physician
  • Rockford, IL
  • NPI 1821391442
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467936000000",
    "number": "1487006854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 W WASHINGTON BLVD",
            "address_2": "SUITE 113",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072203",
            "telephone_number": "888-736-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2081 CALISTOGA DR",
            "address_2": "SUITE #2S",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604514831",
            "telephone_number": "888-736-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACIAK",
        "first_name": "LISA",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-08",
        "last_updated": "2016-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150015479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Psychiatric Services PC (Tom Lelio PC)
• Ptmode LLC
• Surekha Purohit-Buch, M.D.
• Emily Quinn
• Joseph Rabi, M.D.
• Daniel Edward Rady, PSY.D.
• Laura Ragauskaite, M.D.
• Dana M Rains, MS,CCC-SLP
• Daniel Ramirez, M.D.
• Edmar Ramirez

• Social Worker in New Lenox, IL
• Providers in New Lenox, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.