Provider Application

If you share our mission of caring for children with special needs, we want YOU on our team!

Our families are served by healthcare professionals statewide.  We continually strive to partner with healthcare professionals who care for children with special healthcare needs.

It’s easy to become a Division of Specialized Care for Children provider.  We need the following information:

• Training & experience information (DSCC Provider Profile form and CV)
• Tax information (DSCC form or W-9)

If you already do business with the state, we can get some of this information from the IMPACT web portal. To learn about the new provider enrollment system, visit Illinois Medicaid Program Advanced Cloud Technology (IMPACT).

We look forward to answering your questions and assisting you with the application process.