Amber Nicole Shrum, LSW, CADC is a medicare enrolled "Social Worker" provider in Fox Lake, Illinois. Her current practice location is
34 W Grand Ave Unit 101, Fox Lake, Illinois. You can reach out to her office (for appointments etc.) via phone at
(847) 322-2975.
Amber Nicole Shrum is licensed to practice in Illinois (license number 150.114576) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1013720382.
Healthcare Provider's Profile
| Full Name | Amber Nicole Shrum |
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| Gender | Female |
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| Speciality | Social Worker |
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| Location | 34 W Grand Ave Unit 101, Fox Lake, Illinois |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1013720382
- Provider Enumeration Date: 01/29/2025
- Last Update Date: 01/29/2025
Medicare PECOS Information:
- PECOS PAC ID: 6103342878
- Enrollment ID: I20250424003699
Medical Identifiers
Medical identifiers for Amber Nicole Shrum such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1013720382 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 39105 (Illinois) | Secondary |
| 104100000X | Social Worker | 150.114576 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Amber Nicole Shrum allows following entities to bill medicare on her behalf.
| Entity Name | Bailey Behavioral Health Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1790258408
PECOS PAC ID: 0547681058
Enrollment ID: O20200608002967 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amber Nicole Shrum is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Amber Nicole Shrum, LSW, CADC
5807 Bunny Ave,
Mchenry, IL 60051-6268
Ph: () - | Amber Nicole Shrum, LSW, CADC
34 W Grand Ave Unit 101,
Fox Lake, IL 60020-1224
Ph: (847) 322-2975 |
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