Healthcare Provider Details

I. General information

NPI: 1538090584
Provider Name (Legal Business Name): JENIYA ADAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 W BROWN ST
WEST CHICAGO IL
60185-3309
US

IV. Provider business mailing address

219 W BROWN ST
WEST CHICAGO IL
60185-3309
US

V. Phone/Fax

Practice location:
  • Phone: 608-209-9422
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.119217
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: