Active NPI
Kenisha Green
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1023903572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149031840
- Practice address
- 710 S Paulina St Ste 438
Chicago, IL 60612-3808 - Phone
- (312) 563-9196
- NPI assigned
- Jun 12, 2025
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149031840 | IL | Primary |
| Social Worker | 104100000X | IL |
Addresses
Primary practice location
710 S Paulina St Ste 438
Chicago, IL 60612-3808
Mailing address
1053 W 108TH PL
Chicago, IL 60643-3724
Phone (773) 208-8195
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1700 W Van Buren St
Suite 161
Chicago, IL 60612-3228
710 S Paulina St
Suite 438
Chicago, IL 60612-3808
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149031840 | IL | MD | Clinical Social Worker |
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 and National Provider Directory roles.
-
dba Rush University Internists
- Internal Medicine Physician
- Chicago, IL
- NPI 1093819542
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1749686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779753600000",
"number": "1023903572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1053 W 108TH PL",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606433724",
"telephone_number": "773-208-8195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 S PAULINA ST STE 438",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123808",
"telephone_number": "312-563-9196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "KENISHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-06-12",
"last_updated": "2026-05-26",
"certification_date": "2026-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149031840",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": null,
"primary": false
}
],
"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 May 26, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.