AMBER D JELINEK (PSY.D.) – Clinical Psychologist, NPI 1114663051

AMBER D JELINEK (PSY.D.) is a healthcare provider. based in Industry, Illinois. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSY.D.. They hold a License No. 071.008262 (IL). The NPI Number for AMBER D JELINEK (PSY.D.) is 1114663051

Main info

Female
Sole Proprietor
17 Years Of Experience
Accepts Medicare Assignment
Name
AMBER D JELINEK (PSY.D.)
NPI
1114663051
Phone
(417) 343-1432
Address
1930 E 1650TH ST
Enumeration Date
11 May 2022
Last Update Date
11 May 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8884287890
Graduation Year
2009 (17 years ago)
PAC ID
7810341294
Group Practice PAC ID
3971963901
Professional Enrollment ID
I20231004001249
Address ID
IL627116259SP3008XDRXX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

1,600 CLINICAL PSYCHOLOGIST in IL

Provider Addresses for AMBER D JELINEK (PSY.D.)

  • 1930 E 1650TH ST

    INDUSTRY, IL 614409490

    Phone: (417) 343-1432

    Mailing address matches the actual address.

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: 2023-10-04

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
I20231004001249IClinical 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 61440)

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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: 3971963901View full group profile
NameSpecialtyState
Mental Health CounselorIL
Mental Health CounselorIL
Clinical PsychologistIL
Mental Health CounselorIL
Nurse PractitionerIL
Mental Health CounselorIL
Clinical Social WorkerNM
Clinical Social WorkerIL
Nurse PractitionerIL
Clinical Social WorkerIL

Reviews

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Frequently asked questions

How is AMBER D JELINEK (PSY.D.) identified in CMS data?
CMS-hosted NPPES data lists AMBER D JELINEK (PSY.D.) with NPI 1114663051.
Does CMS list AMBER D JELINEK (PSY.D.) as active?
Yes — AMBER D JELINEK (PSY.D.) is active in the NPI listing used on this page.
What taxonomy line describes AMBER D JELINEK (PSY.D.)?
For research purposes, treat AMBER D JELINEK (PSY.D.) as Clinical Psychologist in this dataset. Clinical services aligned with this taxonomy classification.
Where is AMBER D JELINEK (PSY.D.) based?
AMBER D JELINEK (PSY.D.) is tied to Industry, Illinois in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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