Nursing Services are in addition to any Medicaid State Plan nursing services for which the individual qualifies. The need for these services must be documented in the individual's service plan. Nursing Services must be within the scope of the Illinois Nursing and Advanced Practice Nursing Act (225 ILSC 65). Nursing Services are only available to individuals in the Adult DD Waiver who are authorized for Home-Based Support Services (HBS).
Please see the National Plan and Provider Enumeration website for information on applying for a NPI.
Please see the DHS DDD IMPACT information page for more information about enrolling in IMPACT as a DD waiver provider. Nurses
will enroll in IMPACT as Rendering/Servicing providers.
After submitting an IMPACT application, please email Provider Enrollment the IMPACT application ID to ensure that the application is reviewed by a DDD Provider Enrollment Specialist.
This form does not need to be submitted to DHS/DDD. The form should be maintained in the records of the agency that is submitting the
billing for the nursing services.
The following documents must be submitted for a Group Practice to Provider Enrollment:
Department of Human Services
Division of Developmental Disabilities
600 East Ash Street, building 400, Mail Stop 2 South
Springfield, IL 62706
Attention: Provider Enrollment
The business is required to have a type 2 - organizational National Provider Identifier Number (NPI).
Please see web site on National Provider Identification Number
All Nurses that are working for the Group Practice will need to enroll in IMPACT as a Rendering/Service Provider. On Step 3 of the application, the provider will need to enter the NPI for the Group Practice as the billing provider.
Illinois Department of Human ServicesJB Pritzker, Governor · Grace B. Hou, Secretary
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