SHAMMONA CLARK FNP-C
NPI 1235785809
Nurse Practitioner - Family in Chicago, IL
About Shammona Clark Fnp-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHAMMONA CLARK FNP-C (NPI 1235785809) is an individual family provider in Chicago, Illinois, licensed in Illinois (209020109) and active in the NPI registry since August 2019. She is enrolled in Medicare PECOS, is affiliated with Northwestern Medicine Central Dupage Hospital, and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shammona Clark Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
4Medicare enrollment records show Shammona Clark reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Chicago, IL 60616
- Reassigned Medicare billing, Illinois enrollment
Chicago, IL 60611
- Reassigned Medicare billing, Illinois enrollment
- 3 clinicians in this Medicare group
South Holland, IL 60473
- Reassigned Medicare billing, Illinois enrollment
- 57 clinicians in this Medicare group
Chicago, IL 60616
- Reassigned Medicare billing, Illinois enrollment
- 4 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
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Northwestern Medicine Central Dupage Hospital
Acute Care Hospitals · Winfield, ILPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 60617 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Shammona Clark's NPI number?
The NPI number for Shammona Clark is 1235785809. It was assigned to this individual provider in the NPPES registry on August 9, 2019.
Where is Shammona Clark located?
Shammona Clark practices at 2600 S Michigan Ave Ste Lld, Chicago, IL 60617. The listed phone number is (312) 866-4642.
What is Shammona Clark's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Shammona Clark enrolled in Medicare?
Yes. Shammona Clark is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Shammona Clark's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Shammona Clark reassigns Medicare benefits to 4 organizations: Iglow Aesthetics And Med Sp (Chicago, IL), 4D Healthware, LLC (Chicago, IL), Chicagoland Infectious Disease PC (South Holland, IL) and Clark, Nelson, And Associates, Inc. (Chicago, 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 Shammona Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Shammona Clark accept?
Health plans from Ambetter Health list Shammona Clark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Shammona Clark affiliated with any hospitals?
According to CMS data, Shammona Clark is affiliated with Northwestern Medicine Central Dupage Hospital.
When was this NPI record last updated?
The NPPES record for Shammona Clark was last updated on March 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Shammona Clark, FNP-C · NPI 1235785809
Family physician in Chicago, Illinois. Individual provider, active in the CMS NPPES registry since August 9, 2019.
## Identity
- **NPI:** 1235785809 (Entity type: Individual)
- **Enumerated:** August 9, 2019
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 209020109 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 2600 S MICHIGAN AVE, STE LLD, Chicago, IL 60617-3512
- **Phone:** (312) 866-4642
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Iglow Aesthetics And Med Sp (NPI 1477266682, Chicago, IL); 4D Healthware, LLC (NPI 1407333685, Chicago, IL); Chicagoland Infectious Disease PC (NPI 1780002352, South Holland, IL); Clark, Nelson, And Associates, Inc. (NPI 1902457450, Chicago, IL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** March 31, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1235785809) · Data from the CMS NPPES public registry.