Active NPI
Irisha Gerrhea Clark, MD
- Emergency Medicine Physician
- Rockford, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 036168184
- Practice address
- 1401 E State St
Rockford, IL 61104-2315 - Phone
- (779) 696-4400
- NPI assigned
- May 3, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 036168184 | IL | Primary |
Addresses
Primary practice location
1401 E State St
Rockford, IL 61104-2315
Mailing address
1401 E State St
Rockford, IL 61104-2315
Phone (779) 696-4400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1401 E State St
Rockford, IL 61104-2315
Phone (779) 696-4400
1625 S State St
Belvidere, IL 61008-5907
Phone (815) 547-5441
Hospital & facility affiliations
- Uw Health
- Osf Saint Katharine Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.27 of 100
- Quality
- 74.46
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036168184 | IL | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carle Health Care Incorporated | Emergency Medicine | Current | Accepting new patients |
| Osf Multi-Specialty Group | Current | Accepting new patients | |
| Hoopeston Community Memorial Hospital | Emergency Medicine | Current | Accepting new patients |
| Belvidere Emergency Physicians, LLC | Emergency Medicine | Current | Accepting new patients |
| Rockford Emergency Physicians, LLC | Emergency Medicine | Current | Accepting new patients |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Hoopeston Community Memorial Hospital | Current | Accepting new patients | |
| Hoopeston Community Memorial Hospital | Current | Accepting new patients |
Locations
1625 S State St
Belvidere, IL 61008
Phone (815) 544-1846
403 E 1st St
Dixon, IL 61021
Phone (815) 285-5629
701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195
1401 E State St
Rockford, IL 61104
Phone (815) 489-4267
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
Organizations & group practices 8
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medicine Physician
- Belvidere, IL
- NPI 1306543319
-
- Emergency Medicine Physician
- Rockford, IL
- NPI 1639876634
-
- Internal Medicine Physician
- Urbana, IL
- NPI 1154653947
Emergency Medicine
-
- Internal Medicine Physician
- Hoopeston, IL
- NPI 1043683014
Emergency Medicine
-
- Critical Access Hospital
- Hoopeston, IL
- NPI 1366480873
-
- Internal Medicine Physician
- Peoria, IL
- NPI 1922445527
-
- Rural Health Clinic/Center
- Hoopeston, IL
- NPI 1578504544
-
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Dixon, IL
- NPI 1508683590
-
- General Acute Care Hospital
- Rockford, IL
- NPI 1760542732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714003200000",
"number": "1285217760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 E STATE ST",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611042315",
"telephone_number": "779-696-4400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 E STATE ST",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611042315",
"telephone_number": "779-696-4400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "IRISHA",
"middle_name": "GERRHEA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-03",
"last_updated": "2024-04-25",
"certification_date": "2024-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "036168184",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.