KELLY ANN PETTIT (PSYD) – Clinical Psychologist, NPI 1194999409
Clinical Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,600 CLINICAL PSYCHOLOGIST in IL
Provider Addresses for KELLY ANN PETTIT (PSYD)
3701 Doty Rd
Woodstock, IL 600987509
Phone: (815) 338-6600
Fax: (815) 206-5376
Type: Location
4201 W Medical Center Dr
McHenry, IL 600508409
Phone: (815) 338-6600
Fax: (815) 206-5376
Type: Location
10400 Haligus Rd
Huntley, IL 601429553
Phone: (815) 338-6600
Fax: (815) 206-5376
Type: Location
750 E Terra Cotta Ave Ste A
Crystal Lake, IL 600143621
Phone: (815) 344-1999
Fax: (815) 516-5171
Type: Location
755 MCARDLE DR STE C
CRYSTAL LAKE, IL 600141717
Phone: (815) 338-6600
Type: Mailing
Ridgeview Drive, McHenry County, Illinois, 60142, United States
MCHENRY, IL 600507012
Phone: (815) 344-1999
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: 2023-05-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20101021000562 | I | Clinical Psychologist | IL | TBD |
| I20230530002362 | I | Clinical Psychologist | IA | 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 |
|---|---|---|---|---|
| 90834 | Psychotherapy, 45 minutes | 492 | 87 | $0 |
| 90832 | Psychotherapy, 30 minutes | 227 | 112 | $0 |
| 90791 | Psychiatric diagnostic evaluation | 135 | 134 | $0 |
Insurance plans in this area (ZIP 60098)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PSYCHOLOGIST, CLINICAL | IL | 96118 | Neuropsychological testing, interpretation, and report by psychologist or physician per hour | 86 | 25 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Psychologist | IL | |
| Clinical Psychologist | TX | |
| Clinical Social Worker | IL |
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