DR. KEVIN R POLSLEY (M.D.) – Pediatrics Physician, NPI 1093978181
Pediatrics Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
8,828 INTERNAL MEDICINE in IL
Provider Addresses for DR. KEVIN R POLSLEY (M.D.)
15750, Marian Drive, Homer Glen, Will County, Illinois, 60491, United States
HOMER GLEN, IL 604916200
Phone: (708) 645-3400
Type: Mailing
15750 Marian Dr
Homer Glen, IL 604916200
Phone: (708) 645-3400
Type: Location
7425 JANES AVE STE 100
WOODRIDGE, IL 605172357
Phone: (331) 732-7100
Fax: (331) 732-7101
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: 2011-07-28
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110728000254 | I | Internal Medicine | IL | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 497 | 291 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 183 | 183 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 167 | 123 | $0 |
| G0402 | Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment | 17 | 17 | $0 |
Insurance plans in this area (ZIP 60491)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery | IL | |
| Vascular Surgery | IL | |
| - | IL | |
| Nurse Practitioner | IL | |
| - | IL | |
| C H I R O P R A C T I C | IL | |
| Family Practice | IL | |
| Physical Medicine And Rehabilitation | CO | |
| - | IL | |
| Hospitalist, Family Practice | IL |
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