IMELDA N FORSBERG (NURSE PRACTITIONER) – Adult Health Nurse Practitioner, NPI 1306027891
Adult Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for IMELDA N FORSBERG (NURSE PRACTITIONER)
6430 GREENBAY RD
SUITE 104
KENOSHA, WI 531422948
Phone: (262) 925-0535
Fax: (262) 925-0538
Type: Location
1324 N Sheridan Rd
Waukegan, IL 600852161
Phone: (847) 360-3000
Type: Location
6123 GREEN BAY RD STE 120
KENOSHA, WI 531422927
Phone: (262) 358-2954
Type: Mailing
3536 52nd St Ste 1B
Kenosha, WI 531442662
Phone: (262) 925-0535
Fax: (262) 925-0538
Type: Location
111 S Washington Ave Ste 202
Park Ridge, IL 600684293
Phone: (847) 423-6800
Type: Location
6925, 184th Avenue, Village of Bristol, Kenosha County, Wisconsin, 53104, United States
BRISTOL, WI 53104
Phone: (262) 948-1890
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 16 Open Payments records for all available years, with a total value of $321.
Total Amount is formed as General ($321) + Research ($0) + Ownership ($0) = $321.
Last reported payment date: 2024-03-27 • Largest payer in this snapshot: Otsuka America Pharmaceutical, Inc. ($95).
Total Amount
$321
General + Research + Ownership
Payments
16
Total payment records
General Amount
$321
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-03-27
Latest reported date
Top Companies
Largest payers in this snapshot
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: 2012-08-09
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 |
|---|---|---|---|---|
| I20080221000393 | I | Nurse Practitioner | IL | TBD |
| I20120809000834 | I | Nurse Practitioner | WI | 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 53142)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| - | WI |
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