Individual provider Active NPI

Jasmin Roeser, LCSW

  • Clinical Social Worker
  • Waukegan, IL
National Provider Identifier
1558904185
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149018891 Issued in IL
Practice address
2323 Grand Ave
Waukegan, IL 60085-3312
Phone
(847) 666-3494
Fax
(855) 225-3022
NPI assigned
Oct 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149018891 IL Primary

Addresses

Primary practice location

2323 Grand Ave
Waukegan, IL 60085-3312

Mailing address

544 Inverrary LN
Deerfield, IL 60015-3605
Phone (347) 622-6606

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
I20220411002378 IL Practitioner - Clinical Social Worker 4284020629 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erie Family Health Center, IncGroup PAC ID 9537050422, 141 clinicians

Practice addresses (Care Compare)

1701 W Superior St
Chicago, IL 60622-5646
Phone (312) 666-3494

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Erie Family Health Center, Inc CurrentSince Jan 1, 2022 Accepting new patients
Erie Family Health Center Inc CurrentSince Jan 1, 2022 Accepting new patients

Locations

1701 W Superior St
Fl 3
Chicago, IL 60622
Phone (312) 432-7381

1504 S Albany Ave
Chicago, IL 60623

2323 Grand Ave
Waukegan, IL 60085
Phone (847) 666-2427

Organizations & group practices 2

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": "1572134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1558904185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 INVERRARY LN",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600153605",
            "telephone_number": "347-622-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 GRAND AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600853312",
            "telephone_number": "847-666-3494",
            "fax_number": "855-225-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROESER",
        "first_name": "JASMIN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-27",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149018891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

Verify at the official NPI Registry.