MEDICARE: DR. SONIA KENNEDY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	149.030067	IL
2	1041C0700X	Clinical Social Worker	149.030067	IL

General Provider Information

NPI Number	:	1902292972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SONIA KENNEDY

Provider Business Mailing Address
First Line	:	1507 E 53RD ST STE 412
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60615-4573
Country	:	US
Telephone Number	:	773-406-0884
Fax Number	:

Provider Business Practice Location Address
First Line	:	1507 E 53RD ST STE 412
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60615-4573
Country	:	US
Telephone Number	:	773-406-0884
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2015
Last Update Date	:	09/16/2025

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Directions to “ DR. SONIA KENNEDY ” Practice Location

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