Active NPI
Maria Juanita Green
- Clinical Social Worker
- Rockford, IL
National Provider Identifier
1619684883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 3019 N Perryville Rd
Rockford, IL 61114-8016 - Phone
- (815) 975-3330
- NPI assigned
- Oct 27, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 150107081 | IL | |
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
3019 N Perryville Rd
Rockford, IL 61114-8016
Mailing address
2201 Waterbury Dr
Joliet, IL 60431-8584
Phone (773) 641-3044
Other practice location 1
101 1/2 E Front St Ste 104
Wheaton, IL 60187-5334
Phone (630) 216-4038
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: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150107081 | IL | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cozzi Clinical Services LLC | Clinical | Current | Accepting new patients |
Locations
101 E Front St
Ste 104
Wheaton, IL 60187
Phone (630) 216-4038
Organizations & group practices 1
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.
-
- Clinical Social Worker
- Wheaton, IL
- NPI 1275170318
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738022400000",
"number": "1619684883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2201 WATERBURY DR",
"city": "JOLIET",
"state": "IL",
"postal_code": "604318584",
"telephone_number": "773-641-3044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3019 N PERRYVILLE RD",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611148016",
"telephone_number": "815-975-3330"
}
],
"practiceLocations": [
{
"address_1": "101 1/2 E Front St Ste 104",
"address_purpose": "LOCATION",
"city": "Wheaton",
"state": "IL",
"postal_code": "601875334",
"country_code": "US",
"telephone_number": "630-216-4038",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GREEN",
"first_name": "MARIA",
"middle_name": "JUANITA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-27",
"last_updated": "2025-01-28",
"certification_date": "2025-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "150107081",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; 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.