Individual provider Active NPI

Lisa Ann Rawle, B.D.S.

  • Pediatric Dentistry
  • Chicago, IL
National Provider Identifier
1518540285
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
019.035456 Issued in IL
Practice address
Uic Pediatric Dentistry Residency RM 256D (MC 850)
801 S. Paulina St.
Chicago, IL 60613
Phone
(312) 413-7714
Fax
(312) 996-1981
NPI assigned
Apr 30, 2021
Last updated
May 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 019.035456 IL Primary

Addresses

Primary practice location

Uic Pediatric Dentistry Residency RM 256D (MC 850)
801 S. Paulina St.
Chicago, IL 60613

Mailing address

Uic Pediatric Dentistry
801 S. Paulina St. MC 850
Chicago, IL 60612
Phone (866) 600-2273

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: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250430000969 IL Practitioner - Pediatric Dentistry 4587180708 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.035456ILMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince May 16, 2025 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Board of Trustees of the University of Illinois Pediatric Dentistry CurrentSince May 16, 2025 Accepting new patients

Locations

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

801 S Paulina St
#621
Chicago, IL 60612
Phone (312) 355-1661

801 S Paulina St
#850
Chicago, IL 60612
Phone (312) 413-7714

801 S Paulina St
Rm 42
Chicago, IL 60612
Phone (312) 996-6519

Interoperability endpoints

  • Direct secure messaging: lrawle115428@uihealth.direct-ci.com

Organizations & group practices 3

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": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1518540285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UIC PEDIATRIC DENTISTRY",
            "address_2": "801 S. PAULINA ST. MC 850",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "866-600-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UIC PEDIATRIC DENTISTRY RESIDENCY RM 256D (MC 850)",
            "address_2": "801 S. PAULINA ST.",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60613",
            "telephone_number": "312-413-7714",
            "fax_number": "312-996-1981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAWLE",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "B.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-30",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "IL",
            "license": "019.035456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.