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MR. KEVIN M POLKY LCSW
NPI 1902094469
Social Worker - Clinical in Rockford, IL

Active since October 10, 2007PECOS EnrolledAccepts Medicare Assignment
461 N MULFORD RD, CONDO #1, ROCKFORD, IL 61107(815) 395-1141(815) 395-1117 Get Directions Write a Review

NPPES record last updated: October 10, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mr. Kevin M Polky Lcsw NPPES

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

MR. KEVIN M POLKY LCSW (NPI 1902094469) is an individual clinical provider in Rockford, Illinois and active in the NPI registry since October 2007. He is enrolled in Medicare PECOS and is a graduate of Other (1995).

NPPES Registry Identity

NPI1902094469
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. KEVIN M POLKYCredential: LCSW
Location Address461 N MULFORD RD, CONDO #1Rockford, IL 61107-5190
Mailing Address461 N Mulford Rd, Condo #1Rockford, IL 61107-5190 · (815) 395-1141 · Fax (815) 395-1117
Phone(815) 395-1141
Fax(815) 395-1117
Sole ProprietorNo
Medical School CMSOtherGraduated 1995
Enumeration DateOctober 10, 2007
✔ NPI 1902094469 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
461 N MULFORD RD, Rockford, IL 61107
Open in Google Maps ↗

Other Identifiers 1

Medicare UPINK06810IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include MercyCare, MercyCare Health Plans, Quartz.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

Mr. Kevin M Polky Lcsw 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 ID2062499791
PECOS Enrollment IDI20040702000218
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 Kevin Polky reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Fourcorners Wellness Center, Ltd
3.3 mi
Clinical
4001 N PERRYVILLE RD
Loves Park, IL 61111
  • Reassigned Medicare billing, Illinois enrollment
  • Medicare enrollment name: Four Corners Wellness Center, Ltd
  • 7 clinicians in this Medicare group
NPI 1932968633 (815) 988-4370

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61107 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
$0.00 typical visit price
range $54.80 – $168.44
Typical copayment $0.00 (range $13.70 – $42.11)
Most-billed visit code NA
Established Patient
$68.64 typical visit price
range $17.16 – $136.56
Typical copayment $17.16 (range $4.29 – $34.14)
Most-billed visit code 99213
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 9

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

DR. ERROL CHRISTOPHER BAPTIST M.D.
Pediatrics (Adolescent Medicine)
461 N MULFORD RD, SUITE # 4
ROCKFORD, IL 61107
Winnebago County (779) 696-5570
GAIL LOGEMANN LMFT
Marriage & Family Therapist
461 N MULFORD RD, CONDO #1
ROCKFORD, IL 61107
Winnebago County (815) 395-1141
DLX MEDICAL GROUP INC
Family Medicine
461 N MULFORD RD
ROCKFORD, IL 61107
Winnebago County (815) 227-9594
MR. KEVIN D ANDERSON LCSW
Social Worker (Clinical)
461 N MULFORD RD, CONDO #1
ROCKFORD, IL 61107
Winnebago County (815) 395-1141
IGNACIO OMENGAN
Pediatrics (Adolescent Medicine)
461 N MULFORD RD, SUITE #10
ROCKFORD, IL 61107
Winnebago County (815) 394-1930
JENNIFER RADZI LCPC
Counselor (Professional)
461 N MULFORD RD, CONDO #1
ROCKFORD, IL 61107
Winnebago County (815) 395-1141
CATER CHIROPRACTIC CLINIC PC
Chiropractor
461 N MULFORD RD, SUITE 3
ROCKFORD, IL 61107
Winnebago County (815) 227-1600
ERROL C. BAPTIST M.D.
Pediatrics (Adolescent Medicine)
461 N MULFORD RD, SUITE 4
ROCKFORD, IL 61107
Winnebago County (815) 397-2400

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 Kevin Polky's NPI number?

The NPI number for Kevin Polky is 1902094469. It was assigned to this individual provider in the NPPES registry on October 10, 2007.

Where is Kevin Polky located?

Kevin Polky practices at 461 N Mulford Rd Condo #1, Rockford, IL 61107. The listed phone number is (815) 395-1141.

What is Kevin Polky's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Kevin Polky enrolled in Medicare?

Yes. Kevin Polky 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 organization bills Medicare for Kevin Polky's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kevin Polky reassigns Medicare benefits to Fourcorners Wellness Center, Ltd (Loves Park, IL). The 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 Kevin Polky's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kevin Polky accept?

Health plans from MercyCare, MercyCare Health Plans and Quartz list Kevin Polky 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.

When was this NPI record last updated?

The NPPES record for Kevin Polky was last updated on October 10, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.