Coketha Samyra Jean Hendricks, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149019293 Issued in IL

Practice address

2627 W Cermak Rd
Chicago, IL 60608-3514

Phone

(312) 413-3282

Fax

(773) 389-3333

NPI assigned

Jun 23, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Absolutecare of Illinois, PLLC

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1407674104
  Medicare reassignment NPD

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1215553557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 W CERMAK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606083514",
            "telephone_number": "312-413-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 W CERMAK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606083514",
            "telephone_number": "312-413-3282",
            "fax_number": "773-389-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "COKETHA",
        "middle_name": "SAMYRA JEAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-23",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149019293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Henderson
• Aaron Nissan Hendizadeh
• Nina M Hendler, DPT
• Sarah Kay Hendred
• Stephanie Deleon Hendrick, M.D.
• Emily Cull Hendricks, MA
• Kelly J Hendricks, M.A., SLP
• Kemone Hendricks
• Kimberlee Hendricks, DT
• Molly Hendricks

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.