HOLLY A CLARK (N.P.) – Nurse Practitioner, NPI 1205823093
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
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Provider Addresses for HOLLY A CLARK (N.P.)
1860 PAYSPHERE CIR
CHICAGO, IL 606742426
Phone: (630) 469-2000
Type: Mailing
2320, High Street, Blue Island, Calumet Township, Cook County, Illinois, 60406, United States
BLUE ISLAND, IL 604062426
Phone: (708) 388-5500
Type: Location
9024 KINSALE DR
TINLEY PARK, IL 604873899
Phone: (708) 308-6993
Type: Mailing
14315 108TH AVE
ORLAND PARK, IL 604675700
Phone: (815) 300-7764
Fax: (708) 385-8780
Type: Location
15300 WEST AVE STE 224
ORLAND PARK, IL 604624509
Phone: (708) 923-7874
Fax: (708) 923-8596
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 98 Open Payments records for all available years, with a total value of $3,992.
Total Amount is formed as General ($3,992) + Research ($0) + Ownership ($0) = $3,992.
Last reported payment date: 2024-11-20 • Largest payer in this snapshot: ABBVIE INC. ($1,135).
Total Amount
$3,992
General + Research + Ownership
Payments
98
Total payment records
General Amount
$3,992
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $1,135 |
| Lilly USA, LLC | $867 |
| Janssen Pharmaceuticals, Inc | $243 |
| Novo Nordisk Inc | $212 |
| Phathom Pharmaceuticals, Inc. | $204 |
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: 2006-12-07
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 |
|---|---|---|---|---|
| I20061207000088 | I | Nurse Practitioner | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60674)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery | IL | |
| Vascular Surgery | IL | |
| - | IL | |
| Family Practice | IL | |
| Nurse Practitioner | IL | |
| - | IL | |
| Family Practice | IL | |
| Physical Medicine And Rehabilitation | CO | |
| - | IL | |
| Hospitalist, Family Practice | IL |
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