JEAN RIDGEWAY (NURSE PRACTITIONER) – Nurse Practitioner, NPI 1215121314
Nurse Practitioner
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
137 CERTIFIED CLINICAL NURSE SPECIALIST (CNS) in IL
Provider Addresses for JEAN RIDGEWAY (NURSE PRACTITIONER)
1800 Hollister Dr Ste 112
Libertyville, IL 600485265
Phone: (847) 367-6781
Type: Location
Au Bon Pain, 5841, South Maryland Avenue, Hyde Park, Chicago, Hyde Park Township, Cook County, Illinois, 60637, United States
CHICAGO, IL 606371447
Phone: (773) 702-1000
Fax: (773) 834-1918
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $92.
Total Amount is formed as General ($92) + Research ($0) + Ownership ($0) = $92.
Last reported payment date: 2023-04-06 • Largest payer in this snapshot: ADC Therapeutics America, Inc. ($92).
Total Amount
$92
General + Research + Ownership
Payments
1
Total payment records
General Amount
$92
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-04-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ADC Therapeutics America, Inc. | $92 |
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: 2004-08-25
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 |
|---|---|---|---|---|
| I20040825001273 | I | Certified Clinical Nurse Specialist (Cns) | 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 60048)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nephrology, Internal Medicine | IL | |
| A N E S T H E S I O L O G Y | IL | |
| - | MN | |
| - | IL | |
| - | IL | |
| Rheumatology, Internal Medicine | IL | |
| - | IL | |
| Internal Medicine | IL | |
| P S Y C H I A T R Y | IL | |
| - | IL |
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