Jennifer Rafacz, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

071008736 Issued in IL

Practice address

777 Park Ave W
Highland Park, IL 60035-2433

Phone

(847) 432-8000

NPI assigned

Dec 13, 2013

Last updated

Dec 13, 2013By 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 Psychologist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Family InstituteGroup PAC ID 1052460466, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• The Family Institute

  dba The Family Institute at Northwestern University

  • Clinical Psychologist
  • Evanston, IL
  • NPI 1417988155
  Medicare reassignment Care Compare group
• Endeavor Health Medical Group

  dba NorthShore University HealthSystem Faculty Practice Associates

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882
  NPD (past)

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

{
    "created_epoch": "1386892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386892800000",
    "number": "1558792762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 PARK AVE W",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 PARK AVE W",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352433",
            "telephone_number": "847-432-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFACZ",
        "first_name": "JENNIFER",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-13",
        "last_updated": "2013-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071008736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lilian M Pumah, APN
• Qmed Assist, Inc.
• David Rabin, MD
• Eleanor Rabin, M.D.
• Monica Claudia Radu
• Rene Rafi, CRNA
• Gabriel Anthony Rahhal, PA-C
• Rainbow Mental Health, PLLC
• Randal a. Knudson DDS PC (Highland Park Dental Care & Lake Bluff Dental Care)
• Kelly Randall, OTD/OTR

• Psychologist in Highland Park, IL
• Providers in Highland Park, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; 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.