Shirlisa Love, is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Menard, Illinois. Her current practice location is
Menard Correctional Center, 711 E Kaskaskia St., Menard, Illinois. You can reach out to her office (for appointments etc.) via phone at
(618) 826-5071.
Shirlisa Love is licensed to practice in Illinois (license number 209029158) 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 1104691815.
Provider's Profile
Full Name | Shirlisa Love |
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Gender | Female |
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Speciality | Nurse Practitioner - Psychiatric/mental Health |
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Location | Menard Correctional Center, Menard, Illinois |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1104691815
- Provider Enumeration Date: 11/22/2023
- Last Update Date: 01/08/2024
Medicare PECOS Information:
- PECOS PAC ID: 1052836574
- Enrollment ID: I20250506002945
Medical Identifiers
Medical identifiers for Shirlisa Love such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1104691815 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 2023046705 (Missouri) | Secondary |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 209029158 (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. Shirlisa Love allows following entities to bill medicare on her behalf.
Entity Name | Comwell |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1134199037 PECOS PAC ID: 6709848831 Enrollment ID: O20041101000976 |
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Entity Name | Yusuf Salah, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1982254850 PECOS PAC ID: 3577895176 Enrollment ID: O20191031001966 |
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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. Shirlisa Love 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 |
Shirlisa Love, 112 Meadowcrest Dr, Belleville, IL 62221-6749 Ph: (161) 855-0502 | Shirlisa Love, Menard Correctional Center, 711 E Kaskaskia St., Menard, IL 62259 Ph: (618) 826-5071 |
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