Active NPI
Ruby P. Kelly
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1699253732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.002756
- Practice address
- 1525 E 53Rd St Ste 904
Chicago, IL 60615-4572 - Phone
- (312) 203-2370
- Fax
- (331) 288-8613
- NPI assigned
- Jul 31, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149.002756 | IL | Primary |
Addresses
Primary practice location
1525 E 53Rd St Ste 904
Chicago, IL 60615-4572
Mailing address
50 W 71St St Apt 1311
Chicago, IL 60621-3665
Phone (312) 502-2441
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
| License | State | Type | Specialty |
|---|---|---|---|
| 149.002756 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532995200000",
"number": "1699253732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 W 71ST ST APT 1311",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606213665",
"telephone_number": "312-502-2441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1525 E 53RD ST STE 904",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606154572",
"telephone_number": "312-203-2370",
"fax_number": "331-288-8613"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "RUBY",
"middle_name": "P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-31",
"last_updated": "2018-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.002756",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.