Jeff Charles Rastatter, M.D.

Primary specialty

Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X

License

036118993 Issued in IL

Practice address

225 E. Chicago Ave., #25
Ann & Robert H. Lurie Children's Hospital of Chicago
Chicago, IL 60611-2605

Phone

(312) 227-6230

Fax

(312) 227-9414

NPI assigned

Apr 18, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Lurie Children's Medical Group, LLC

  dba LCMG

  • Pediatrics Physician
  • Chicago, IL
  • NPI 1992758544
  NPD (past)

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366156800000",
    "number": "1932326451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E. CHICAGO AVE., #25",
            "address_2": "ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112605",
            "telephone_number": "312-227-6230",
            "fax_number": "312-227-9414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E. CHICAGO AVE., #25",
            "address_2": "ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112605",
            "telephone_number": "312-227-6230",
            "fax_number": "312-227-9414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASTATTER",
        "first_name": "JEFF",
        "middle_name": "CHARLES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2013-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "IL",
            "license": "036118993",
            "primary": true
        },
        {
            "code": "207YS0012X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "OH",
            "license": "35.088062",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "036-118993",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "760060",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PTAN",
            "identifier": "760060002",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nelly Rasmussen
• William Douglas Rasmussen III, D.C.
• Hassam Rasool, MD
• Venice T Rasoulis
• James Raspanti, DO
• Gregory Raster, MD
• Mary Rastetter
• Alok Rastogi, M.D.
• Kevin James Rasuli, MD
• Mark Ratain

• Pediatric Otolaryngology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatric Otolaryngology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.