Individual provider Active NPI

Marina Lisjonok, LCSW

  • Social Worker
  • Glen Ellyn, IL
National Provider Identifier
1497373872
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
45 S Park Blvd Ste 200
Glen Ellyn, IL 60137-6282
Phone
(630) 423-5935
NPI assigned
Jul 11, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

45 S Park Blvd Ste 200
Glen Ellyn, IL 60137-6282

Mailing address

800 Roosevelt Rd Ste C206
Glen Ellyn, IL 60137-5851
Phone (630) 423-5935

Other practice location 1

800 Roosevelt Rd Ste C206
Glen Ellyn, IL 60137-5851
Phone (630) 423-5935

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
I20250903002792 IL Practitioner - Clinical Social Worker 9234631953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Life Care Wellness, Inc.Group PAC ID 2860791449, 14 clinicians

Practice addresses (Care Compare)

800 Roosevelt Rd
Suite C206
Glen Ellyn, IL 60137-5851
Phone (630) 423-5935

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Life Care Wellness, Inc. Social Worker CurrentSince May 22, 2025 Accepting new patients

Locations

800 Roosevelt Rd
Ste C206
Glen Ellyn, IL 60137
Phone (630) 423-5935

45 S Park Blvd
Ste 200
Glen Ellyn, IL 60137
Phone (630) 423-5935

Organizations & group practices 1

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": "1594425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1497373872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 ROOSEVELT RD STE C206",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601375851",
            "telephone_number": "630-423-5935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 S PARK BLVD STE 200",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601376282",
            "telephone_number": "630-423-5935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Roosevelt Rd Ste C206",
            "address_purpose": "LOCATION",
            "city": "Glen Ellyn",
            "state": "IL",
            "postal_code": "601375851",
            "country_code": "US",
            "telephone_number": "630-423-5935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LISJONOK",
        "first_name": "MARINA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-11",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Ellyn, IL

Sources for this page

Verify at the official NPI Registry.