Individual provider Active NPI

Deanne Lois Drechsler Bajaj, LCSW

  • Clinical Social Worker
  • Bloomington, IL
National Provider Identifier
1891036893
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.015391 Issued in IL
Practice address
2422 E Washington St Ste 109
Bloomington, IL 61704-1611
Phone
(815) 408-0202
NPI assigned
Mar 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 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 149.015391 IL Primary

Addresses

Primary practice location

2422 E Washington St Ste 109
Bloomington, IL 61704-1611

Mailing address

2604 Red Rock Rd
Normal, IL 61761-6438
Phone (708) 704-2585

Other practice location 1

2604 Red Rock Rd
Normal, IL 61761-6438
Phone (708) 704-2585

Other names 1

  • Deanne Lois Drechsler Former name

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
I20140610002231 IL Practitioner - Clinical Social Worker 6901020064 Practice locations: Normal, IL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.015391ILMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1363305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1891036893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 RED ROCK RD",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617616438",
            "telephone_number": "708-704-2585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2422 E WASHINGTON ST STE 109",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617041611",
            "telephone_number": "815-408-0202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2604 Red Rock Rd",
            "address_purpose": "LOCATION",
            "city": "Normal",
            "state": "IL",
            "postal_code": "617616438",
            "country_code": "US",
            "telephone_number": "708-704-2585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAJAJ",
        "first_name": "DEANNE",
        "middle_name": "LOIS DRECHSLER",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-15",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.015391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEANNE",
            "last_name": "DRECHSLER",
            "middle_name": "LOIS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.