NICOLE ANNE CLEM (ARNP) – Nurse Practitioner, NPI 1023405222
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for NICOLE ANNE CLEM (ARNP)
5841 S MARYLAND AVE
CHICAGO, IL 606371443
Phone: (888) 824-0200
Type: Location
1619 CREIGHTON RD
STE 1
PENSACOLA, FL 325047152
Phone: (850) 444-4700
Fax: (850) 444-7497
Type: Mailing
150 HARVESTER DR STE 300
BURR RIDGE, IL 605275965
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $20.
Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.
Last reported payment date: 2023-01-11 • Largest payer in this snapshot: PFIZER INC. ($20).
Total Amount
$20
General + Research + Ownership
Payments
1
Total payment records
General Amount
$20
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-01-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| PFIZER INC. | $20 |
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: 2023-03-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20150611000889 | I | Nurse Practitioner | AL | TBD |
| I20200810000068 | I | Nurse Practitioner | IL | TBD |
| I20230317002392 | I | Nurse Practitioner | CA | TBD |
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.
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 60637)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | IL | |
| N E U R O L O G Y | IL | |
| General Surgery | IN | |
| Pediatric Medicine, Emergency Medicine | IL | |
| - | IL | |
| - | IL | |
| Cardiovascular Disease (Cardiology) | IL | |
| Internal Medicine | IL | |
| Nurse Practitioner | MI | |
| Interventional Cardiology, Internal Medicine, Cardiovascular Disease (Cardiology) | IL |
Reviews
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