Shelli Pollard, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Poplar Grove, Illinois. Her current practice location is
117 Minarette Dr Sw, Poplar Grove, Illinois. You can reach out to her office (for appointments etc.) via phone at
(815) 575-9887.
Shelli Pollard is licensed to practice in Illinois (license number 149018509) 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 1053786269.
Healthcare Provider's Profile
Full Name | Shelli Pollard |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 117 Minarette Dr Sw, Poplar Grove, Illinois |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1053786269
- Provider Enumeration Date: 12/14/2015
- Last Update Date: 01/25/2024
Medicare PECOS Information:
- PECOS PAC ID: 2567724479
- Enrollment ID: I20180313000029
Medical Identifiers
Medical identifiers for Shelli Pollard such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1053786269 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1041C0700X | Social Worker - Clinical | 149018509 (Illinois) | 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. Shelli Pollard allows following entities to bill medicare on her behalf.
Entity Name | Grow Healthcare Group Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220414000139 |
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Entity Name | Revive Therapy And Wellness Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1780446476 PECOS PAC ID: 7618312711 Enrollment ID: O20240228003395 |
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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. Shelli Pollard 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 |
Shelli Pollard, LCSW 117 Minarette Dr Sw, Poplar Grove, IL 61065-8538 Ph: (815) 575-9887 | Shelli Pollard, LCSW 117 Minarette Dr Sw, Poplar Grove, IL 61065-8538 Ph: (815) 575-9887 |
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