JENNIFER A NICHOLS (ACNPC-AG) – Acute Care Nurse Practitioner, NPI 1336745785
Acute Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
Provider Addresses for JENNIFER A NICHOLS (ACNPC-AG)
303 E Army Trail Rd
Bloomingdale, IL 601082169
Phone: (224) 653-8946
Type: Location
3743 Highland Ave
Downers Grove, IL 605151594
Phone: (630) 967-6125
Type: Location
5143 GRAND AVE
DOWNERS GROVE, IL 605155120
Phone: (630) 742-9419
Type: Mailing
1890 Silver Cross Blvd Ste 350
New Lenox, IL 604519603
Phone: (815) 717-8737
Fax: (815) 717-8699
Type: Location
1890 SILVER CROSS BLVD STE 350
NEW LENOX, IL 604519603
Phone: (815) 717-8737
Fax: (815) 717-8699
Type: Location
701 WINTHROP AVE
GLENDALE HEIGHTS, IL 601391405
Phone: (630) 545-8000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $48.
Total Amount is formed as General ($48) + Research ($0) + Ownership ($0) = $48.
Last reported payment date: 2023-08-29 • Largest payer in this snapshot: ShockWave Medical, Inc ($28).
Total Amount
$48
General + Research + Ownership
Payments
2
Total payment records
General Amount
$48
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-08-29
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ShockWave Medical, Inc | $28 |
| Surmodics, Inc. | $20 |
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: 2021-06-01
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 |
|---|---|---|---|---|
| I20210601000692 | 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 60108)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | IL | |
| - | IL | |
| Radiation Oncology | NC | |
| - | IL | |
| - | IL | |
| - | OK | |
| U R O L O G Y | AR | |
| Internal Medicine | IL | |
| Emergency Medicine | IL | |
| Family Practice | IL |
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