Individual provider Active NPI

Pauline Mainou Kingwergs

  • Counselor
  • Chicago, IL
National Provider Identifier
1790660751
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
178.021871 Issued in IL
Practice address
3047 N Lincoln Ave # 201
Chicago, IL 60657-4999
Phone
(773) 494-5505
NPI assigned
Aug 8, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 178.021871 IL Primary

Addresses

Primary practice location

3047 N Lincoln Ave # 201
Chicago, IL 60657-4999

Mailing address

3734 N Sheffield Ave Apt GS
Chicago, IL 60613-5066

Other names 1

  • Pauline Mainou Other name

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
178.021871ILMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1754611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1790660751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3734 N SHEFFIELD AVE APT GS",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3047 N LINCOLN AVE # 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574999",
            "telephone_number": "773-494-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAINOU KINGWERGS",
        "first_name": "PAULINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-08",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "178.021871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAULINE",
            "last_name": "MAINOU",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Aug 8, 2025; 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.