Individual provider Active NPI

Jenna Genre, CNM

  • Advanced Practice Midwife
  • Chicago, IL
National Provider Identifier
1487329439
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
209023755 Issued in IL
Practice address
3750 W Ogden Ave
Chicago, IL 60623-2426
Phone
(872) 588-3000
NPI assigned
Aug 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 209023755 IL Primary

Addresses

Primary practice location

3750 W Ogden Ave
Chicago, IL 60623-2426

Mailing address

1532 N Kedzie Ave Apt 3F
Chicago, IL 60651-0702
Phone (817) 201-1220

Other identifiers 2

IdentifierTypeStateIssuer
209023755OtherILSTATE LICENSE
309017555OtherILCS LICENSE

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210927002541 IL Practitioner - Certified Nurse Midwife (CNM) 5890192215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lawndale Christian Health CenterGroup PAC ID 2264336346, 124 clinicians

Practice addresses (Care Compare)

3860 W Ogden Ave
Chicago, IL 60623-2460
Phone (872) 588-3000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lawndale Christian Health Center CurrentSince Aug 11, 2021 Accepting new patients
Lawndale Christian Health Center CurrentSince Aug 15, 2021 Accepting new patients
Lawndale Christian Health Center CurrentSince Aug 11, 2021 Accepting new patients
Lawndale Christian Health Center Current Accepting new patients

Locations

4696 Paysphere Cir
Chicago, IL 60674

3860 W Ogden Ave
Chicago, IL 60623
Phone (872) 588-3000

3750 W Ogden Ave
Chicago, IL 60623
Phone (872) 588-3000

Interoperability endpoints

  • Direct secure messaging: jgenre690789@direct.ochin.org

Organizations & group practices 4

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": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1487329439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1532 N KEDZIE AVE APT 3F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606510702",
            "telephone_number": "817-201-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 W OGDEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606232426",
            "telephone_number": "872-588-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENRE",
        "first_name": "JENNA",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-11",
        "last_updated": "2023-03-07",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209023755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "209023755",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CS LICENSE",
            "identifier": "309017555",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.