Individual provider Active NPI

Keydi Tejeda, LSW

  • Social Worker
  • Urbana, IL
National Provider Identifier
1578402111
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150118264 Issued in IL
Practice address
1803 Philo Rd
Urbana, IL 61802-6015
Phone
(773) 340-2465
NPI assigned
Mar 27, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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 150118264 IL Primary

Addresses

Primary practice location

1803 Philo Rd
Urbana, IL 61802-6015

Mailing address

2501 Myers CT Apt 2
Champaign, IL 61822-6856
Phone (708) 664-6536

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
150118264ILMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1774569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774569600000",
    "number": "1578402111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 MYERS CT APT 2",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618226856",
            "telephone_number": "708-664-6536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 PHILO RD",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618026015",
            "telephone_number": "773-340-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEJEDA",
        "first_name": "KEYDI",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-27",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150118264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2026; 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.