Active NPI
Rae E Rich, LCSW
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1982641627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149002472
- Practice address
- 1509 W Berwyn Ave
Suite 209
Chicago, IL 60640-8056 - Phone
- (847) 687-3085
- NPI assigned
- Jun 1, 2006
- 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 | 149002472 | IL | Primary |
Addresses
Primary practice location
1509 W Berwyn Ave
Suite 209
Chicago, IL 60640-8056
Mailing address
1509 W Berwyn Ave
Suite 209
Chicago, IL 60640-8056
Phone (847) 687-3085
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1623160 | Other | IL | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 13, 2022 through Nov 13, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396915200000",
"number": "1982641627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1509 W BERWYN AVE",
"address_2": "SUITE 209",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606408056",
"telephone_number": "847-687-3085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1509 W BERWYN AVE",
"address_2": "SUITE 209",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606408056",
"telephone_number": "847-687-3085"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICH",
"first_name": "RAE",
"middle_name": "E",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-01",
"last_updated": "2014-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149002472",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "1623160",
"state": "IL"
}
],
"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 Apr 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.