Individual provider Active NPI

Ronald E Pajak, LSW

  • Social Worker
  • Chicago, IL
National Provider Identifier
1871867044
Registry record updated Mar 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150.013219 Issued in IL
Practice address
180 N Michigan Ave
Suite 410
Chicago, IL 60601-7401
Phone
(312) 925-7800
NPI assigned
Mar 5, 2012
Last updated
Mar 5, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150.013219 IL Primary

Addresses

Primary practice location

180 N Michigan Ave
Suite 410
Chicago, IL 60601-7401

Mailing address

180 N Michigan Ave
Suite 410
Chicago, IL 60601-7401
Phone (312) 925-7800

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
I20220725000616 IL Practitioner - Clinical Social Worker 9234510124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5115 N Ravenswood Ave
FL 2
Chicago, IL 60640-2712
Phone (312) 925-7800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
150.013219ILMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ravenco Inc CurrentSince May 4, 2022 Accepting new patients
Ravenswood Counseling Center CurrentSince Jul 25, 2021 Accepting new patients

Locations

5115 N Ravenswood Ave
Fl 2
Chicago, IL 60640
Phone (312) 925-7800

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, 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": "1330905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330905600000",
    "number": "1871867044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 N MICHIGAN AVE",
            "address_2": "SUITE 410",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017401",
            "telephone_number": "312-925-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 N MICHIGAN AVE",
            "address_2": "SUITE 410",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017401",
            "telephone_number": "312-925-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAJAK",
        "first_name": "RONALD",
        "middle_name": "E",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-05",
        "last_updated": "2012-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.013219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.