MRS. MAKENNA GREEN (MA, SLP) – Speech-Language Pathologist, NPI 1467004697

MRS. MAKENNA GREEN (MA, SLP) is a healthcare provider. based in St charles, Illinois. specializing in QUALIFIED SPEECH LANGUAGE PATHOLOGIST. They hold the professional credentials MA, SLP. They hold a License No. 242.005419 (IL). The NPI Number for MRS. MAKENNA GREEN (MA, SLP) is 1467004697

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
MRS. MAKENNA GREEN (MA, SLP)
NPI
1467004697
Phone
(630) 677-4409
Address
420 HAMILTON RD
Enumeration Date
9 July 2019
Last Update Date
9 July 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8157531481
Graduation Year
2018 (8 years ago)
PAC ID
8022489186
Group Practice PAC ID
2860440195
Professional Enrollment ID
I20230127000964
Address ID
IL601159621DE3100XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:6State licenses:1Digital endpointsOther names

446 QUALIFIED SPEECH LANGUAGE PATHOLOGIST in IL

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Provider Addresses for MRS. MAKENNA GREEN (MA, SLP)

  • Hamilton Road, Stanford, Waldorf, Charles County, Maryland, 20601, United States

    ST CHARLES, IL 601758009

    Phone: (630) 677-4409

    Type: Mailing

  • East Main Street, St. Charles, Kane County, Illinois, 60184, United States

    ST CHARLES, IL 601745202

    Phone: (630) 793-4464

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-01-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230127000964IQualified Speech Language PathologistILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60175)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2860440195View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeIL
Qualified AudiologistIL
Qualified AudiologistIL
Physical Therapist In Private PracticeIL
Qualified AudiologistIL
Qualified AudiologistIL
Qualified Speech Language PathologistIL
-IL
Qualified Speech Language PathologistIL
Qualified Speech Language PathologistIL

Reviews

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Frequently asked questions

What identifier follows MRS. MAKENNA GREEN (MA, SLP) across health systems?
The NPI 1467004697 uniquely identifies MRS. MAKENNA GREEN (MA, SLP) in U.S. healthcare data.
Is MRS. MAKENNA GREEN (MA, SLP)'s NPI status active today?
Active status means MRS. MAKENNA GREEN (MA, SLP)'s NPI record is not deactivated in the public file.
How should patients interpret MRS. MAKENNA GREEN (MA, SLP)'s specialty?
The extract shows Speech-Language Pathologist for MRS. MAKENNA GREEN (MA, SLP). Clinical services aligned with this taxonomy classification.
What geographic area is tied to MRS. MAKENNA GREEN (MA, SLP)?
MRS. MAKENNA GREEN (MA, SLP) is associated with St Charles, Illinois in the same public data insurers reference.
Who maintains MRS. MAKENNA GREEN (MA, SLP)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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