Jeannine Hasenfang, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

150013501 Issued in IL

Practice address

6220 Misty Pines Dr
Tinley Park, IL 60477-5434

Phone

(773) 272-1938

NPI assigned

Aug 28, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• The Board of Trustees of the University of Illinois

  • Occupational Medicine Physician
  • Chicago, IL
  • NPI 1043727571
  NPD
• The Board of Trustees of the University of Illinois

  • Federally Qualified Health Center (FQHC)
  • Rockford, IL
  • NPI 1306486022
  NPD
• The Board of Trustees of the University of Illinois

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1669493466
  NPD

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

{
    "created_epoch": "1630108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630108800000",
    "number": "1922775733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6220 MISTY PINES DR",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604775434",
            "telephone_number": "773-272-1938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6220 MISTY PINES DR",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604775434",
            "telephone_number": "773-272-1938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASENFANG",
        "first_name": "JEANNINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-28",
        "last_updated": "2021-08-28",
        "certification_date": "2021-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "150013501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Laptop",
            "affiliation": "N",
            "address_1": "6220 Misty Pines Dr",
            "city": "Tinley Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604775434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amaya Hardin
• Diana Harmon
• Delvon Harris
• Letrice Harris, TRICHOLOGY
• Ronnie Harwell
• Omar Hassad, RPH
• Sara Hastings, CRC, LPC
• Kristin Elizabeth Hatch, MS, OTR/L
• Chloe Hatcher
• Kessy Ann Haubenreiser, PHARMD

• Clinical Social Worker in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2021; 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.

Verify at the official NPI Registry.