Theresa Pendergraff

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149018482 Issued in IL

Practice address

4150 N Kilbourn Ave
Chicago, IL 60641-1913

Phone

(312) 342-8155

NPI assigned

Jan 8, 2018

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

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Teleo Logistics LLC

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1518640457
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1515369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1245747542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 N KILBOURN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606411913",
            "telephone_number": "312-342-8155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 N KILBOURN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606411913",
            "telephone_number": "312-342-8155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENDERGRAFF",
        "first_name": "THERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-08",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149018482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Penalver
• Melissa M. Penas, M.D.
• Douglas F Penate, M.D.
• Ashley Pender
• Kathleen Marie Pendergast, LCPC
• Paul B Pendler, PSY.D.
• Jeress T Pendleton
• Nicole C Pendleton, LMT
• Anne Peneff-Albert, D.C.
• Chengwei Peng, MD

• 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 Dec 27, 2022; 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.

Verify at the official NPI Registry.