AMY J POLIVKA FNP-C
NPI 1710751706
Nurse Practitioner - Family in Downers Grove, IL

Q: What is Amy Polivka's NPI number?

The NPI number for Amy Polivka is 1710751706. It was assigned to this individual provider in the NPPES registry on November 9, 2023.

Q: What is Amy Polivka's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Amy Polivka was last updated on December 19, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 November 09, 2023PECOS Enrolled

2736 MAPLE AVE, DOWNERS GROVE, IL 60515(630) 963-0080 Get Directions Write a Review

NPPES record last updated: December 19, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 11, 2023, Nov 9, 2023 (2 updates tracked since 2023).

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About Amy J Polivka Fnp-c NPPES

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

AMY J POLIVKA FNP-C (NPI 1710751706) is an individual family provider in Downers Grove, Illinois, licensed in Illinois (209028721) and active in the NPI registry since November 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710751706

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameAMY J POLIVKACredential: FNP-C

Location Address2736 MAPLE AVEDowners Grove, IL 60515-4201

Mailing Address2736 Maple AveDowners Grove, IL 60515-4201 · (630) 963-0080

Phone(630) 963-0080

Sole ProprietorNo

Enumeration DateNovember 9, 2023

Last NPPES UpdateDecember 19, 20232 updates tracked since enumeration

NPPES CertifiedDecember 19, 2023

✔ NPI 1710751706 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in IL · 209028721

2736 MAPLE AVE, Downers Grove, IL 60515

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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)

Amy J Polivka Fnp-c 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60515 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

$93.02 typical visit price

range $59.81 – $181.38

Typical copayment $23.25 (range $14.95 – $45.34)

Most-billed visit code 99203

Established Patient

$105.07 typical visit price

range $19.15 – $147.12

Typical copayment $26.26 (range $4.78 – $36.78)

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 7

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

TYLER DEROSIA DC, ATC

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