JENIFER MARIE CHAMBLESS (PA-C) – Physician Assistant, NPI 1962549790
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
Provider Addresses for JENIFER MARIE CHAMBLESS (PA-C)
305 W Jackson St
SUITE 200
Carbondale, IL 629011474
Phone: (618) 453-3777
Fax: (618) 453-1102
Type: Location
PO BOX 19639
SPRINGFIELD, IL 627949639
Phone: (217) 545-8000
Fax: (844) 470-2486
Type: Mailing
300 W OAK ST
CARBONDALE, IL 629011400
Phone: (618) 536-6621
Fax: (618) 453-1102
Type: Location
305, West Jackson Street, Carbondale, Jackson County, Illinois, 62901, United States
STE 200
CARBONDALE, IL 629011474
Phone: (618) 453-7777
Fax: (618) 453-1102
Type: Mailing
300 W Oak St Ste 100
Carbondale, IL 629011496
Phone: (618) 536-6621
Fax: (618) 453-1102
Type: Location
2553 Ken Gray Blvd
West Frankfort, IL 628964174
Phone: (618) 932-3937
Fax: (618) 932-2734
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: 2010-08-05
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 |
|---|---|---|---|---|
| I20100805000472 | I | Physician Assistant | 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 62901)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | IL | |
| Physician Assistant | IL | |
| Family Practice | IL | |
| Registered Dietitian Or Nutrition Professional | IL | |
| Clinical Social Worker | IL | |
| Nurse Practitioner | IL | |
| Mental Health Counselor | IL | |
| - | IL | |
| Internal Medicine | OK | |
| Family Practice | IL |
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