HOLLY A CLARK N.P.
NPI 1205823093
Nurse Practitioner in Orland Park, IL
About Holly A Clark N.p. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HOLLY A CLARK N.P. (NPI 1205823093) is an individual nurse practitioner in Orland Park, Illinois, licensed in Illinois (277-000934) and active in the NPI registry since October 2005. She is enrolled in Medicare PECOS, is affiliated with Palos Community Hospital, and is a graduate of Other (1997).
NPPES Registry Identity
Specialties & Licenses
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
Holly A Clark N.p. 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.
Medicare Billing Reassignments
2Medicare enrollment records show Holly Clark reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Orland Park, IL 60487
- Reassigned Medicare billing, Illinois enrollment
- 44 clinicians in this Medicare group
Carol Stream, IL 60122
- Reassigned Medicare billing, Illinois enrollment
- 1,664 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare 3
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Palos Community Hospital
Acute Care Hospitals · Palos Heights, ILSilver Cross Hospital And Medical Centers
Acute Care Hospitals · New Lenox, ILNorthwestern Medicine Central Dupage Hospital
Acute Care Hospitals · Winfield, ILPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 60462 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Holly Clark's NPI number?
The NPI number for Holly Clark is 1205823093. It was assigned to this individual provider in the NPPES registry on October 5, 2005.
Where is Holly Clark located?
Holly Clark practices at 15300 West Ave Ste 224, Orland Park, IL 60462. The listed phone number is (708) 923-8260.
What is Holly Clark's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Holly Clark enrolled in Medicare?
Yes. Holly Clark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Holly Clark's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Holly Clark reassigns Medicare benefits to 2 organizations: Premier Suburban Medical Group, PLLC (Orland Park, IL) and Central Dupage Physician Group (Carol Stream, IL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Holly Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Holly Clark affiliated with any hospitals?
According to CMS data, Holly Clark is affiliated with Palos Community Hospital, Silver Cross Hospital And Medical Centers and Northwestern Medicine Central Dupage Hospital.
When was this NPI record last updated?
The NPPES record for Holly Clark was last updated on October 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.
# Holly A Clark, N.P. · NPI 1205823093
Nurse Practitioner physician in Orland Park, Illinois. Individual provider, active in the CMS NPPES registry since October 5, 2005.
## Identity
- **NPI:** 1205823093 (Entity type: Individual)
- **Enumerated:** October 5, 2005
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** 277-000934 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 15300 WEST AVE STE 224, Orland Park, IL 60462-4509
- **Phone:** (708) 923-8260
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Premier Suburban Medical Group, PLLC (NPI 1902412950, Orland Park, IL); Central Dupage Physician Group (NPI 1033149844, Carol Stream, IL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1997
## Record status
- **NPPES last updated:** October 29, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1205823093) · Data from the CMS NPPES public registry.