Timetra Diane Clark, FNP-BC - Medicare Nurse Practitioner in Chicago, IL

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Timetra Diane Clark, FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Chicago, Illinois. She graduated from nursing school in 2021 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. Her current practice location is 1401 E 55th St Apt 905n, Chicago, Illinois. You can reach out to her office (for appointments etc.) via phone at (708) 759-3112.

Timetra Diane Clark is licensed to practice in Illinois (license number 209024791) and she also participates in the medicare program. She may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1316687650.

Contact Information

Timetra Diane Clark, FNP-BC
1401 E 55th St Apt 905n,
Chicago, IL 60615-5468
(708) 759-3112
Not Available

Map and Direction




Provider's Profile

Full NameTimetra Diane Clark
GenderFemale
SpecialityNurse Practitioner
Experience5 Years
Location1401 E 55th St Apt 905n, Chicago, Illinois
Accepts Medicare AssignmentsMay be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Timetra Diane Clark graduated from nursing school in 2021
  NPI Data:
  • NPI Number: 1316687650
  • Provider Enumeration Date: 04/01/2022
  • Last Update Date: 04/01/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 5294117230
  • Enrollment ID: I20260626003239

Medical Identifiers

Medical identifiers for Timetra Diane Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1316687650NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163WN0300XRegistered Nurse - Nephrology 041436444 (Illinois)Secondary
163WN0300XRegistered Nurse - Nephrology 9562544 (Florida)Secondary
363L00000XNurse Practitioner 209024791 (Illinois)Secondary
363LF0000XNurse Practitioner - Family 209024791 (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. Timetra Diane Clark allows following entities to bill medicare on her behalf.
Entity NameConsonant Healing Associates of De LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1669099321
PECOS PAC ID: 2466871694
Enrollment ID: O20210325000520

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. Timetra Diane 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 AddressPractice Location Address
Timetra Diane Clark, FNP-BC
1401 E 55th St Apt 905n,
Chicago, IL 60615-5468

Ph: (708) 759-3112		Timetra Diane Clark, FNP-BC
1401 E 55th St Apt 905n,
Chicago, IL 60615-5468

Ph: (708) 759-3112

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.