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JEROME CLARK
NPI 1013465145
Counselor - Mental Health in Waukegan, IL

Active since September 19, 2016PECOS Enrolled
671 S LEWIS AVE, WAUKEGAN, IL 60085(847) 782-4000 Get Directions Write a Review

NPPES record last updated: September 19, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jerome Clark NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEROME CLARK (NPI 1013465145) is an individual mental health provider in Waukegan, Illinois and active in the NPI registry since September 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1013465145
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameJEROME CLARK
Location Address671 S LEWIS AVEWaukegan, IL 60085-6101
Mailing Address671 S Lewis AveWaukegan, IL 60085-6101
Phone(847) 782-4000
Sole ProprietorYes
Enumeration DateSeptember 19, 2016
✔ NPI 1013465145 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
671 S LEWIS AVE, Waukegan, IL 60085
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jerome Clark is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. STEPHANIE REBECCA SCHLAPPI-KINDRED M.A., LPC
Counselor (Professional)
671 S LEWIS AVE
WAUKEGAN, IL 60085
Lake County (847) 782-4151
SAMANTHA ANN NIERMAN
Social Worker
671 S LEWIS AVE
WAUKEGAN, IL 60085
Lake County (847) 782-4128
ERIKA DENNY MSW
Social Worker
671 S LEWIS AVE
WAUKEGAN, IL 60085
Lake County (773) 998-8648
MRS. HEATHER MARIE STEWART BSW
Social Worker
671 S LEWIS AVE
WAUKEGAN, IL 60085
Lake County (847) 782-4000
MRS. CARLA R. GUTIERREZ DOMINGUEZ LCSW
Social Worker (Clinical)
671 S LEWIS AVE
WAUKEGAN, IL 60085
Lake County (847) 782-4156
MARY ELLEN NASH MSW,LSW
Social Worker
671 S LEWIS AVE
WAUKEGAN, IL 60085
Lake County (847) 782-4113
CHAKEYSHA JASMINE MCKINNEY-LYONS
Marriage & Family Therapist
671 S LEWIS AVE
WAUKEGAN, IL 60085
Lake County (847) 782-4000
JANETH BRINDIS
Social Worker
671 S LEWIS AVE
WAUKEGAN, IL 60085
Lake County (847) 782-4287

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jerome Clark's NPI number?

The NPI number for Jerome Clark is 1013465145. It was assigned to this individual provider in the NPPES registry on September 19, 2016.

Where is Jerome Clark located?

Jerome Clark practices at 671 S Lewis Ave, Waukegan, IL 60085. The listed phone number is (847) 782-4000.

What is Jerome Clark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Jerome Clark enrolled in Medicare?

Yes. Jerome Clark is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jerome Clark was last updated on September 19, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.