Candace Clark, in Blue Island, IL - Medicare Social Worker Provider

Candace Clark, is a medicare enrolled "Social Worker - Clinical" provider in Blue Island, Illinois. Her current practice location is 13136 Western Ave, Blue Island, Illinois. You can reach out to her office (for appointments etc.) via phone at (708) 974-5864.

Candace Clark is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1619534203.

Contact Information

	Candace Clark,
	13136 Western Ave, Blue Island, IL 60406-2423
	(708) 974-5864
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Candace Clark
Gender	Female
Speciality	Social Worker - Clinical
Location	13136 Western Ave, Blue Island, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1619534203
Provider Enumeration Date: 05/20/2019
Last Update Date: 12/03/2021

Medicare PECOS Information:

PECOS PAC ID: 9638525975
Enrollment ID: I20231024000517

Medical Identifiers

Medical identifiers for Candace Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1619534203	NPI	-	NPPES
362167940	Medicaid	IL

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	(* (Not Available))	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Candace Clark allows following entities to bill medicare on her behalf.

Entity Name	Clarity Clinic Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1063803856 PECOS PAC ID: 7517284755 Enrollment ID: O20150326001469

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Candace Clark is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Candace Clark, 10534 S Walden Pkwy, Chicago, IL 60643-2623 Ph: (708) 829-0179	Candace Clark, 13136 Western Ave, Blue Island, IL 60406-2423 Ph: (708) 974-5864

Reviews and Comments

Social Worker in Blue Island, IL

Ms. Juliet Ann Russom Walden, BS, AM, LSCW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 13136 Western Ave, Blue Island, IL 60406 Phone: 708-974-5800
Amanda Keenan, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 3046 127th St, Blue Island, IL 60406 Phone: 708-377-7920 Fax: 708-930-0414
Kristen Hofman, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 13136 Western Ave, Blue Island, IL 60406 Phone: 708-974-5800
Jessica Null, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 12331 Gregory St, Blue Island, IL 60406 Phone: 708-489-7338
Mr. George Fay Henry Jr., LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 12311 Meadow Ln, Unit 1b, Blue Island, IL 60406 Phone: 312-504-5560
Meghan Kelly, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 13136 Western Ave, Blue Island, IL 60406 Phone: 708-974-5800 Fax: 708-974-2498

Candace Clark, - Medicare Clinical Social Worker in Blue Island, IL