Active NPI
Mary Kidney, LCSW
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1841715323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149019111
- Practice address
- 2601 W Marquette Rd
Chicago, IL 60629-1817 - Phone
- (773) 565-2550
- Fax
- (773) 565-2571
- NPI assigned
- Aug 7, 2017
- 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 | 149019111 | IL | Primary |
Addresses
Primary practice location
2601 W Marquette Rd
Chicago, IL 60629-1817
Mailing address
2746 W Logan Blvd
Chicago, IL 60647-1870
Phone (703) 307-2218
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149019111 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502064000000",
"number": "1841715323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2746 W LOGAN BLVD",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606471870",
"telephone_number": "703-307-2218",
"fax_number": "773-565-2571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2601 W MARQUETTE RD",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606291817",
"telephone_number": "773-565-2550",
"fax_number": "773-565-2571"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIDNEY",
"first_name": "MARY",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-07",
"last_updated": "2017-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149019111",
"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 Aug 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.