Individual provider Active NPI

Rochelle Ann Siegel, LCSW

  • Clinical Social Worker
  • Evanston, IL
National Provider Identifier
1710310834
Registry record updated Aug 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149009628 Issued in IL
Practice address
2141 Ridge Ave
Suite 3D
Evanston, IL 60201-2769
Phone
(312) 399-4636
Fax
(847) 724-9280
NPI assigned
Aug 13, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2013

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 149009628 IL Primary

Addresses

Primary practice location

2141 Ridge Ave
Suite 3D
Evanston, IL 60201-2769

Mailing address

2141 Ridge Ave
Suite 3D
Evanston, IL 60201-2769
Phone (312) 399-4636

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
I20140703000649 IL Practitioner - Clinical Social Worker 7113142290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1974
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Eaves Health Partners PLLCGroup PAC ID 2466844220, 19 clinicians

Practice addresses (Care Compare)

5151 Church St
Skokie, IL 60077-1123
Phone (773) 436-6600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376352000000",
    "number": "1710310834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2141 RIDGE AVE",
            "address_2": "SUITE 3D",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602012769",
            "telephone_number": "312-399-4636",
            "fax_number": "847-724-9280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 RIDGE AVE",
            "address_2": "SUITE 3D",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602012769",
            "telephone_number": "312-399-4636",
            "fax_number": "847-724-9280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGEL",
        "first_name": "ROCHELLE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-13",
        "last_updated": "2013-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149009628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.