Active NPI
Jenaya Anderson
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1902544463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149021625
- Practice address
- 1136 S Delano CT W Ste B201
Chicago, IL 60605-3734 - Phone
- (708) 845-5500
- Fax
- (708) 845-5505
- NPI assigned
- May 24, 2022
- Last updated
- May 24, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149021625 | IL | Primary |
Addresses
Primary practice location
1136 S Delano CT W Ste B201
Chicago, IL 60605-3734
Mailing address
15127 S 73Rd Ave Ste G
Orland Park, IL 60462-3425
Phone (708) 845-5500
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 |
|---|---|---|---|
| 149021625 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653350400000",
"number": "1902544463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15127 S 73RD AVE STE G",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604623425",
"telephone_number": "708-845-5500",
"fax_number": "708-845-5505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1136 S DELANO CT W STE B201",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606053734",
"telephone_number": "708-845-5500",
"fax_number": "708-845-5505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "JENAYA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-24",
"last_updated": "2022-05-24",
"certification_date": "2022-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149021625",
"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 May 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.