1. Home
  2. Directory
  3. Illinois
  4. Loves Park
  5. Social Worker
  6. NPI Profile

FOURCORNERS WELLNESS CENTER, LTD
NPI 1932968633
Social Worker - Clinical in Loves Park, IL

Active since March 15, 2024
4001 N PERRYVILLE RD, LOVES PARK, IL 61111(815) 988-4370 Get Directions Write a Review

NPPES record last updated: March 15, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Fourcorners Wellness Center, Ltd NPPES

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

FOURCORNERS WELLNESS CENTER, LTD (NPI 1932968633) is a healthcare organization registered as a clinical in Loves Park, Illinois and active in the NPI registry since March 2024. The organization lists Kevin M Polky, Founder/president, as its authorized official.

NPPES Registry Identity

NPI1932968633
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameFOURCORNERS WELLNESS CENTER, LTD
Location Address4001 N PERRYVILLE RDLoves Park, IL 61111-8644
Mailing Address4001 N Perryville RdLoves Park, IL 61111-8644 · (815) 988-4370
Phone(815) 988-4370
Organization SubpartNo
Authorized OfficialKevin M PolkyFounder/president · (815) 988-4370
Enumeration DateMarch 15, 2024
NPPES CertifiedMarch 15, 2024
✔ NPI 1932968633 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.
4001 N PERRYVILLE RD, Loves Park, IL 61111
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Fourcorners Wellness Center, Ltd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Fourcorners Wellness Center, Ltd, which bills Medicare for the services they deliver. Of these, 6 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (7)

Arianna Calkins, LCSW
Clinical Social Worker
NPI 1750075677
695 N PERRYVILLE RD STE 4
Rockford, IL 61107
(779) 368-0060
✔ PECOS✔ Accepts Medicare3.0 mi
James Johnson
Mental Health Counselor
NPI 1083189120
695 N PERRYVILLE RD
Rockford, IL 61107
(779) 368-0060
✔ PECOS✔ Accepts Medicare3.0 mi
Kevin Polky, LCSW
Clinical Social Worker
NPI 1902094469
461 N MULFORD RD CONDO #1
Rockford, IL 61107
(815) 395-1141
✔ PECOS✔ Accepts Medicare3.3 mi
George Spangler, L.P.C.
Mental Health Counselor
NPI 1710259759
3815 HARRISON AVE
Rockford, IL 61108
(815) 391-1000
✔ PECOS✔ Accepts Medicare6.4 mi
Cody Berillo, LCSW
Clinical Social Worker
NPI 1871292995
6392 LINDEN RD
Rockford, IL 61109
(779) 368-0060
✔ PECOS✔ Accepts Medicare7.0 mi
Sonya Mcdevitt, LCPC
Mental Health Counselor
NPI 1154803070
6392 LINDEN RD
Rockford, IL 61109
(779) 368-0060
✔ PECOS✔ Accepts Medicare7.0 mi
Amara Rafiq, LPC
Mental Health Counselor
NPI 1730820036
998 N LOMBARD RD
Lombard, IL 60148
(630) 474-4414
✔ PECOS✔ Accepts Medicare57 mi

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

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 Fourcorners Wellness Center, Ltd's NPI number?

The NPI number for Fourcorners Wellness Center, Ltd is 1932968633. It was assigned to this organization in the NPPES registry on March 15, 2024.

Where is Fourcorners Wellness Center, Ltd located?

Fourcorners Wellness Center, Ltd is located at 4001 N Perryville Rd, Loves Park, IL 61111. The listed phone number is (815) 988-4370.

What is Fourcorners Wellness Center, Ltd's specialty?

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

Is Fourcorners Wellness Center, Ltd enrolled in Medicare?

Yes. Fourcorners Wellness Center, Ltd is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Fourcorners Wellness Center, Ltd?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 2 Medicare specialties reassign their Medicare billing to Fourcorners Wellness Center, Ltd. A 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 the clinician's services. The largest specialties are Mental Health Counselor (4) and Clinical Social Worker (3). Of these, 6 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Fourcorners Wellness Center, Ltd accept?

Health plans from MercyCare, MercyCare Health Plans and Quartz list Fourcorners Wellness Center, Ltd 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 Fourcorners Wellness Center, Ltd was last updated on March 15, 2024. 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.