Sandra Clark, PHD in Quincy, IL - Medicare Psychologist Provider

Sandra Clark, PHD is a medicare enrolled "Psychologist - Clinical" provider in Quincy, Illinois. Her current practice location is 1025 Maine St, Quincy, Illinois. You can reach out to her office (for appointments etc.) via phone at (217) 222-6550.

Sandra Clark is licensed to practice in Illinois (license number 071-009935) 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 1235602293.

Contact Information

	Sandra Clark, PHD
	1025 Maine St, Quincy, IL 62301-4096
	(217) 222-6550
	(217) 277-2253

Map and Direction

Healthcare Provider's Profile

Full Name	Sandra Clark
Gender	Female
Speciality	Psychologist - Clinical
Location	1025 Maine St, Quincy, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1235602293
Provider Enumeration Date: 01/02/2019
Last Update Date: 09/10/2019

Medicare PECOS Information:

PECOS PAC ID: 4789912726
Enrollment ID: I20190828003395

Medical Identifiers

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

Identifier	Type	State	Issuer
1235602293	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103TC0700X	Psychologist - Clinical	071-009935 (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. Sandra Clark allows following entities to bill medicare on her behalf.

Entity Name	Quincy Physicians & Surgeons Clinic, Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1548234198 PECOS PAC ID: 0749192375 Enrollment ID: O20031103000445

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. Sandra 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
Sandra Clark, PHD 1025 Maine St, Quincy, IL 62301-4096 Ph: (217) 222-6550	Sandra Clark, PHD 1025 Maine St, Quincy, IL 62301-4096 Ph: (217) 222-6550

Reviews and Comments

Psychologist in Quincy, IL

Dr. Michael Joseph Schneider, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1231 Maine St, Suite # 1, Quincy, IL 62301 Phone: 217-228-1887 Fax: 217-228-1884
John Joseph Venegoni, SCHOOL PSYCHOLOGIST Psychologist Medicare: Not Enrolled in Medicare Practice Location: 6808 Oak Ridge Ln, Quincy, IL 62305 Phone: 217-430-2234
Brian Bangert, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1416 Maine St, Quincy, IL 62301 Phone: 217-223-8700
Brittney Moore, PHD Psychologist Medicare: Medicare Enrolled Practice Location: 927 Broadway St, Quincy, IL 62301 Phone: 217-224-4453
Ethan Dwight Lantz, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 6020 Broadway St, Quincy, IL 62305 Phone: 217-224-3366
Alexis Reid, Psychologist Medicare: Not Enrolled in Medicare Practice Location: 4900 Columbus Rd, Quincy, IL 62305 Phone: 217-228-7117

Sandra Clark, PHD - Medicare Psychologist in Quincy, IL