Individual provider Active NPI

Lisa Ladd Szudarski, LCSW

  • Clinical Social Worker
  • Warrenville, IL
National Provider Identifier
1679084222
Registry record updated Oct 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-007593 Issued in IL
Practice address
27475 Ferry Rd Ste 110
Warrenville, IL 60555-3808
Phone
(630) 363-1429
NPI assigned
Oct 22, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2017

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 149-007593 IL Primary

Addresses

Primary practice location

27475 Ferry Rd Ste 110
Warrenville, IL 60555-3808

Mailing address

27475 Ferry Rd
Warrenville, IL 60555-3808
Phone (630) 363-1429

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
I20260514000832 IL Practitioner - Clinical Social Worker 5294204715 Practice locations: Warrenville, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1106 Westhaven Dr
Wheaton, IL 60189-6147

27475 Ferry Rd
Suite 110
Warrenville, IL 60555-3808
Phone (630) 363-1429

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-007593ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1508630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508630400000",
    "number": "1679084222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27475 FERRY RD",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553808",
            "telephone_number": "630-363-1429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27475 FERRY RD STE 110",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553808",
            "telephone_number": "630-363-1429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SZUDARSKI",
        "first_name": "LISA",
        "middle_name": "LADD",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-22",
        "last_updated": "2017-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-007593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenville, IL

Sources for this page

Verify at the official NPI Registry.