Individual provider Active NPI

Kendra Dirienzo, WHNP,CNM

  • Women's Health Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1346057940
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
209030841 Issued in IL
Practice address
570 E 115TH St
Chicago, IL 60628-5740
Phone
(773) 768-5000
NPI assigned
Dec 17, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 209030841 IL Primary

Addresses

Primary practice location

570 E 115TH St
Chicago, IL 60628-5740

Mailing address

4211 N Winchester Ave Apt 1
Chicago, IL 60613-1013
Phone (608) 709-6469

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9119 S Exchange Ave
Chicago, IL 60617-4225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
209030841ILMDWomen's Health Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: kendra.dirienzo.1@18277.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1734393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1346057940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 N WINCHESTER AVE APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606131013",
            "telephone_number": "608-709-6469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 E 115TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606285740",
            "telephone_number": "773-768-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIRIENZO",
        "first_name": "KENDRA",
        "credential": "WHNP,CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-17",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IL",
            "license": "209030841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.