Individual provider Active NPI

Marlene Pena, LSW

  • Social Worker
  • Chicago, IL
National Provider Identifier
1063155208
Registry record updated Apr 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150.107243 Issued in IL
Practice address
2000 N Racine Ave Ste 3300
Chicago, IL 60614-7008
Phone
(773) 413-9523
NPI assigned
Apr 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150.107243 IL Primary

Addresses

Primary practice location

2000 N Racine Ave Ste 3300
Chicago, IL 60614-7008

Mailing address

2000 N Racine Ave # 3000
Chicago, IL 60614-7006
Phone (773) 413-9523

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

LicenseStateTypeSpecialty
150.107243ILMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Abbie Kelley, LLC CurrentSince Apr 17, 2022 Accepting new patients

Locations

2000 N Racine Ave
Ste 3300
Chicago, IL 60614
Phone (773) 413-9523

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.

NPI Registry JSON

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

{
    "created_epoch": "1649980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650153600000",
    "number": "1063155208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 N RACINE AVE # 3000",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606147006",
            "telephone_number": "773-413-9523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 N RACINE AVE STE 3300",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606147008",
            "telephone_number": "773-413-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "MARLENE",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-15",
        "last_updated": "2022-04-17",
        "certification_date": "2022-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150.107243",
            "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 Apr 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.