PAMELA GRACE (PHD) – Psychologist, NPI 1063451680

PAMELA GRACE (PHD) is a healthcare provider. based in Morris, Illinois. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 071004356 (IL). The NPI Number for PAMELA GRACE (PHD) is 1063451680

Main info

Female
37 Years Of Experience
Accepts Medicare Assignment
Name
PAMELA GRACE (PHD)
NPI
1063451680
Phone
(815) 942-6323
Address
1401 LAKEWOOD DR
Enumeration Date
6 June 2006
Last Update Date
24 May 2023

Doctor Profile

Medical School Name
UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Secondary Phone
6308932210
Graduation Year
1989 (37 years ago)
PAC ID
7517955032
Group Practice PAC ID
5496667941
Professional Enrollment ID
I20040504000636
Address ID
IL601082201BL30XXXDRXX300
Telehealth
Yes

Contacts

Secure Messaging
pgrace205889@direct.edward.org
Secure Messaging
pgrace205889@dulyhealthandcare.direct-ci.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

1,600 CLINICAL PSYCHOLOGIST in IL

Provider Addresses for PAMELA GRACE (PHD)

  • 1401, Lakewood Drive, Morris, Grundy County, Illinois, 60450, United States

    SUITE A

    MORRIS, IL 604503352

    Phone: (815) 942-6323

    Fax: (815) 942-6423

    Type: Mailing

  • PO BOX 713260

    CHICAGO, IL 606740264

    Phone: (630) 469-9200

    Type: Mailing

  • PO BOX 7410264

    CHICAGO, IL 606740264

    Phone: (815) 942-6323

    Fax: (779) 210-5541

    Type: Mailing

  • 1239 WINDHAM PKWY

    ROMEOVILLE, IL 604461608

    Phone: (815) 942-6323

    Fax: (779) 210-5541

    Type: Location

  • 1280, Windham Parkway, Romeoville, Will County, Illinois, 60446, United States

    ROMEOVILLE, IL 604461673

    Phone: (815) 942-6323

    Fax: (815) 942-6423

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2004-05-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040504000636IClinical PsychologistILTBD

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.

Verify on CMS Revalidation Lookup Tool

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 60450)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5496667941View full group profile
NameSpecialtyState
E N D O C R I N O L O G YIL
Physician AssistantIL
Internal MedicineIL
Nurse PractitionerIL
-IL
-IL
-IL
-IL
-IL
Physical Therapist In Private PracticeIL

Reviews

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Frequently asked questions

What number should I use to identify PAMELA GRACE (PHD) for billing?
Administrative and clinical systems typically use NPI 1063451680 for PAMELA GRACE (PHD).
Is PAMELA GRACE (PHD)'s NPI status active today?
Active status means PAMELA GRACE (PHD)'s NPI record is not deactivated in the public file.
Which specialty label fits PAMELA GRACE (PHD)?
NPPES ties PAMELA GRACE (PHD) to Psychologist in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to PAMELA GRACE (PHD)?
PAMELA GRACE (PHD) is associated with Morris, Illinois in the same public data insurers reference.
Why is information missing for PAMELA GRACE (PHD)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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