Nichole N Clark, APNP in Mchenry, IL - Medicare Nurse Practitioner

Nichole N Clark, APNP is a medicare enrolled "Nurse Practitioner - Family" in Mchenry, Illinois. She graduated from nursing school in 2019 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Advocate Health And Hospitals Corporation and her current practice location is 633 Ridgeview Dr, Mchenry, Illinois. You can reach out to her office (for appointments etc.) via phone at (815) 344-0621.

Nichole N Clark is licensed to practice in Illinois (license number 209019549) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1093377905.

Contact Information

	Nichole N Clark, APNP
	633 Ridgeview Dr, Mchenry, IL 60050-7012
	(815) 344-0621
	(815) 344-0664

Map and Direction

Provider's Profile

Full Name	Nichole N Clark
Gender	Female
Speciality	Nurse Practitioner
Experience	5 Years
Location	633 Ridgeview Dr, Mchenry, Illinois
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Nichole N Clark graduated from nursing school in 2019

NPI Data:

NPI Number: 1093377905
Provider Enumeration Date: 07/01/2019
Last Update Date: 12/14/2023

Medicare PECOS Information:

PECOS PAC ID: 6800121062
Enrollment ID: I20190710000954

Medical Identifiers

Medical identifiers for Nichole N Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1093377905	NPI	-	NPPES
1093377905	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	10067 (Wisconsin)	Secondary
363LF0000X	Nurse Practitioner - Family	209019549 (Illinois)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Advocate Good Shepherd Hospital	Barrington, IL	Hospital
Ssm Health St Mary's Hospital - Janesville	Janesville, WI	Hospital
Ssm Health St Mary's Hospital - Madison	Madison, WI	Hospital
Northwestern Medicine Mchenry Hospital	Mchenry, IL	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Advocate Health And Hospitals Corporation	7810800935	2422

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. Nichole N Clark allows following entities to bill medicare on her behalf.

Entity Name	Advocate Health And Hospitals Corporation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1700824455 PECOS PAC ID: 7810800935 Enrollment ID: O20031106000064

Entity Name	Journeycare, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1154324994 PECOS PAC ID: 2062578305 Enrollment ID: O20090512000566

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. Nichole N Clark 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
Nichole N Clark, APNP 29373 Network Pl, Chicago, IL 60673-2334 Ph: (847) 390-5900	Nichole N Clark, APNP 633 Ridgeview Dr, Mchenry, IL 60050-7012 Ph: (815) 344-0621

Reviews and Comments

Nurse Practitioner Nurses in Mchenry, IL

Mrs. Josette Dutcher, APRN-BC, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3925 W Elm St, Mchenry, IL 60050 Phone: 800-323-8622 Fax: 224-225-0396
Magaly Nickles, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4309 W Medical Center Dr Ste B305, Mchenry, IL 60050 Phone: 847-802-7400
Lindsay Ann Mattes, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3901 Mercy Dr, Mchenry, IL 60050 Phone: 815-363-9900
Katarzyna Maria Brozek, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4201 W Medical Center Dr, Mchenry, IL 60050 Phone: 815-344-5000
Tanya Tanzillo, CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2507 N Richmond Rd, Mchenry, IL 60051 Phone: 815-338-6600 Fax: 815-759-4078
Carrie A Hauck, APRN, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4201 W Medical Center Dr, Mchenry, IL 60050 Phone: 815-334-5566 Fax: 815-759-4008

Nichole N Clark, APNP - Medicare Nurse Practitioner in Mchenry, IL