Active NPI
Lindsay Roettger
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1972295616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149027326
- Practice address
- 2600 S Michigan Ave Ste 104
Chicago, IL 60616-2857 - Phone
- (224) 275-1712
- NPI assigned
- May 22, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149027326 | IL | Primary |
Addresses
Primary practice location
2600 S Michigan Ave Ste 104
Chicago, IL 60616-2857
Mailing address
1317 Kensington Dr
Mundelein, IL 60060-1096
Phone (219) 309-5967
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149027326 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kelly Behrends, PSYD, PC | Past | Accepting new patients |
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.
-
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- Libertyville, IL
- NPI 1962632463
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722988800000",
"number": "1972295616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1317 KENSINGTON DR",
"city": "MUNDELEIN",
"state": "IL",
"postal_code": "600601096",
"telephone_number": "219-309-5967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 S MICHIGAN AVE STE 104",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606162857",
"telephone_number": "224-275-1712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROETTGER",
"first_name": "LINDSAY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-22",
"last_updated": "2024-08-07",
"certification_date": "2024-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149027326",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.