CCPA Recredentialing Process
Here is the CCPA Recredentialing Checklist for you to use. This checklist was created to give you a detailed list of items needed to submit to CCPA for recredentialing.
CCPA Recredentialing Important Items
Support Documents Needed
- Signed CCPA Attestation Form*
- Signed Page Two (2) of Illinois Application
- All Current Professional License(s) [i.e., State Medical License(s), etc.]
- Current State Controlled Substance License
- Current Board Certification Certificate
- Current Federal Drug Enforcement Administration Certificate
- Current Certificate of Insurance
- Current Curriculum Vitae
*Please click here to access all CCPA forms listed above.
To view the CCPA recredentialing criteria in more detail, please review the CCPA Credentialing Policies and Procedures.