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How to use or fill out Schedule E - Medical Director or Physician (pdf) - Illinois - dhs state il with DocHub
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Click ‘Get Form’ to open it in the editor.
Begin by entering the Facility Name at the top of the form. This identifies the location where you will be practicing.
Fill in your personal details, including your Name, Sex, Social Security Number, Position, Date of Birth, Place of Birth, and Residence Address. Ensure accuracy for verification purposes.
Provide your contact information by filling in the City, State, and Zip Code along with your Telephone Number.
List your Professional Registration Numbers and indicate if they are in good standing by selecting 'Yes' or 'No'.
Complete the sections regarding your Illinois Professional Medical License Number and any other relevant licenses.
Answer questions about previous convictions and professional practices honestly. Include details about any associations with alcoholism and substance abuse programs.
Finally, read through the Department of Human Services Rule Part 2060 statement before signing and dating the form to confirm your understanding.
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How do you become a director qualified in Illinois?
In California, a Medical Director must be a licensed physician due to the Corporate Practice of Medicine (CPOM) doctrine. Unlike some states, California does not allow Nurse Practitioners (NPs) or Physician Assistants (PAs) to independently serve as Medical Directors or own medical practices, including med spas.
Who can be a medical director in Illinois?
Requires an Illinois license to practice medicine and completion of approved residency in the position related medical specialty of psychiatry, rehabilitation, medicine, or other specialty clinically appropriate. Requires four years of substantive medical administrative experience in clinical program direction.
How do I report a doctor to the medical board in Illinois?
Illinois State Medical Board Phone. (888) 473-4858. TTY Line. (866) 325-4949. Complaints. (312) 814-6910. Prof. Licensing. (800) 560-6420.
Who qualifies as a medical director?
While some health care organizations require their medical directors to be M.D.s, others require a masters degree in a health-related field such as health administration or public health, such as USCs MPH program.
Can a nurse practitioner be a medical director in Illinois?
APRNs with a full practice authority license may serve as a medical director to Illinois medical spas.
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➢ Schedule E for medical director, additional physicians and physician extenders ➢ Notify IDHS/SUPR within 10 calendar days of any change in medical director.
Handbook for Practitioners Rendering Medical Services
Jun 16, 2021 For purposes of this handbook, a practitioner is a health care professional or entity rendering medical services and enrolled with HFS as one of
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