JUDI KITTLE FORNER
NPI 1194123679
Clinical Nurse Specialist - Adult Health in Mchenry, IL

Q: What is Judi Forner's NPI number?

The NPI number for Judi Forner is 1194123679. It was assigned to this individual provider in the NPPES registry on December 15, 2014. The provider is also known as Ms. Judi Lynne Kittle Apn, Acns, Rn.

Q: What is Judi Forner's specialty?

The primary specialty registered for this NPI is Clinical Nurse Specialist, specializing in Adult Health, with taxonomy code 364SA2200X.

Q: When was this NPI record last updated?

The NPPES record for Judi Forner was last updated on October 19, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since December 15, 2014PECOS EnrolledAccepts Medicare Assignment

4309 W MEDICAL CENTER DR STE A200, MCHENRY, IL 60050(815) 759-8070(815) 759-4931 Get Directions Write a Review

NPPES record last updated: October 19, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 19, 2018, Aug 13, 2018, Jul 26, 2018 (3 updates tracked since 2018).

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About Judi Kittle Forner NPPES

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

JUDI KITTLE FORNER (NPI 1194123679) is an individual adult health provider in Mchenry, Illinois, licensed in Illinois (209010514) and active in the NPI registry since December 2014. She is enrolled in Medicare PECOS, is affiliated with Osf Saint Elizabeth Mdl Ctr, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1194123679

Entity TypeIndividualFemale

Primary Taxonomy364SA2200X

Provider Legal NameJUDI KITTLE FORNER

Location Address4309 W MEDICAL CENTER DR STE A200Mchenry, IL 60050

Mailing Address4309 W Medical Center Dr Ste A200Mchenry, IL 60050-8437 · (815) 759-8070 · Fax (815) 759-4931

Phone(815) 759-8070

Fax(815) 759-4931

Sole ProprietorNo

Medical School CMSOtherGraduated 2012

Enumeration DateDecember 15, 2014

Last NPPES UpdateOctober 19, 20183 updates tracked since enumeration

✔ NPI 1194123679 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical Nurse Specialist · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code364SA2200X

License✔ Licensed in IL · 209010514

4309 W MEDICAL CENTER DR STE A200, Mchenry, IL 60050

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Other Names 1

Former Name (1)Ms. Judi Lynne Kittle Apn, Acns, Rn

Secondary Practice Locations 3

Location 110370 Haligus Rd Ste 200Huntley, IL 60142-9582 · Phone (815) 759-8070 · Fax (815) 759-4931

Location 2360 Station Dr Fl 3Crystal Lake, IL 60014-7978 · Phone (815) 759-8070 · Fax (815) 759-4931

Location 35666 E State StRockford, IL 61108-2425 · Phone (815) 227-2657 · Fax (815) 395-5381

Other Identifiers 1

Other209010514IL · State License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Dean Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Judi Kittle Forner is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3577848035

PECOS Enrollment IDI20170323001908

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.

Medicare Billing Reassignment

Medicare enrollment records show Judi Forner reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Osf Multi-Specialty Group

127 mi

Internal Medicine

8600 N STATE ROUTE 91
Peoria, IL 61615

Reassigned Medicare billing, Illinois enrollment
2,944 clinicians in this Medicare group

NPI 1154908929 (309) 683-5050

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

684 services587 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

12 services12 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Osf Saint Elizabeth Mdl Ctr

Acute Care Hospitals · Ottawa, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140110

Location1100 E Norris DriveOttawa, IL 61350 · La Salle County

Emergency services Birthing friendly

Fhn Memorial Hospital

Acute Care Hospitals · Freeport, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number140160

Location1045 West Stephenson StreetFreeport, IL 61032 · Stephenson County

Emergency services Birthing friendly

Saint Anthony Medical Center

Acute Care Hospitals · Rockford, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140233

Location5666 East State StreetRockford, IL 61108 · Winnebago County

Emergency services Birthing friendly

Osf Saint Paul Medical Center

Critical Access Hospitals · Mendota, IL

OwnershipVoluntary non-profit - Church

CMS Certification Number141310

Location1401 E 12th StreetMendota, IL 61342 · La Salle County

Emergency services

Rochelle Community Hospital

Critical Access Hospitals · Rochelle, IL

OwnershipVoluntary non-profit - Private

CMS Certification Number141312

Location900 N 2nd StRochelle, IL 61068 · Ogle County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60050 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$127.46 typical visit price

range $54.80 – $168.44

Typical copayment $31.86 (range $13.70 – $42.11)

Most-billed visit code 99204

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DR. ASIM R ZAIDI M.D.

Internal Medicine (Interventional Cardiology)