A summary of Illinois’ collaboration, agreement, filing, supervision, prescribing, and specialty rules for NPs and the physicians who collaborate with them.
Collaborating Physician Required? Yes
Physician Involvement: Standard, then transitions to Independent after 4,000 hours
Agreement Name: Written collaborative agreement
On-Site Requirements: None
Chart Review: No fixed count; medication orders reviewed periodically (only where prescribing is delegated)
Controlled Substances: Allowed with an Illinois mid-level controlled substance license and federal DEA (physician delegation required)
Reduced Supervision / Transition Requirements: 250 hours of continuing education/training + 4,000 clinical hours to full practice authority (no agreement required)
Illinois NP Collaboration Requirements Summary
Illinois nurse practitioners must practice under a written collaborative agreement with a collaborating physician, but Illinois also offers a path to full practice authority. Illinois is a reduced-involvement collaborative state: the physician does not have to be on-site, and once an NP completes 250 hours of continuing education or training plus 4,000 hours of clinical experience, the NP can practice independently without a collaborating physician.
Source: 225 ILCS 65/65-43(b)
Type of Collaborative Relationship
Illinois NPs work under a written collaborative agreement with a collaborating physician who must be reachable but is not required to be physically present, and Illinois provides a full practice authority pathway that removes the agreement entirely. There is no cap on how many NPs a physician may collaborate with, other than a rule against so many agreements that the physician cannot adequately collaborate. Illinois law does not automatically make the collaborating physician legally responsible for the NP’s care. After 250 hours of continuing education or training and 4,000 hours of clinical experience, an NP can move to full practice authority.
Source: 225 ILCS 65/65-43(b)
What is an NP’s scope of practice in Illinois?
Illinois NPs may assess, diagnose, treat, and prescribe within the scope of their training and experience, working either under a written collaborative agreement or, once qualified, with full practice authority. A collaborative agreement may not restrict the categories of patients an NP treats within their training and experience.
Do NPs need a collaborating physician in Illinois?
Yes, unless they qualify for full practice authority. Most Illinois NPs must have a written collaborative agreement with a physician, but an NP who completes 250 hours of continuing education or training and 4,000 hours of clinical experience no longer needs one.
Can NPs practice independently in Illinois?
Yes, once qualified. An NP who files a notarized attestation of 250 hours of continuing education or training plus 4,000 hours of clinical experience after national certification can practice with full practice authority and no collaborative agreement.
How many NPs can a physician supervise in Illinois?
Illinois sets no fixed number. A physician may not enter into so many written collaborative agreements that they are unable to adequately collaborate with each NP.
Who can be a collaborating physician in Illinois?
Illinois sets no specific qualification requirements to be a collaborating physician. The statute does not impose minimum years of practice or board-certification conditions.
Are there proximity or in-person requirements in Illinois?
No. The collaborative relationship does not require the physician’s personal presence where services are rendered; communication must simply be available in person, by telecommunication, or electronically as set out in the agreement.
Collaboration Agreement Requirements
Illinois’s agreement is called a written collaborative agreement, and it must describe the relationship between the NP and physician, describe the categories of care, treatment, or procedures the NP will provide, and be defined to promote the NP’s professional judgment. It may not restrict the categories of patients within the NP’s training and experience, limit the payors or government health programs the NP contracts with, or limit the NP’s geographic area or practice location. Signatures of both the physician and NP are required when controlled-substance prescribing is delegated, and in that case a copy must be kept at each location where the NP practices. Illinois does not provide a state template and sets no fixed review or renewal schedule.
Source: 225 ILCS 65/65-35(b)
What must be included in an NP collaborative agreement in Illinois?
The agreement must describe the relationship between the NP and collaborating physician, describe the categories of care, treatment, or procedures the NP will provide, and be written to promote the NP’s professional judgment. It may not restrict patient categories within the NP’s training, limit which payors or government programs the NP contracts with, or limit the NP’s geographic area or practice location.
What is the collaborative agreement called in Illinois?
It is called a written collaborative agreement — Illinois’s term for the written arrangement between an NP and a collaborating physician.
Who has to sign the collaborative agreement in Illinois?
Both the physician and the NP must sign when controlled-substance prescribing is delegated, and a signed copy must be kept at each location where the NP practices. Illinois does not otherwise mandate signatures.
How often must the agreement be reviewed or renewed in Illinois?
Illinois sets no specific requirement. There is no fixed review or renewal schedule for the collaborative agreement.
Is a backup physician required in Illinois?
No. Illinois does not require a backup physician.
Board Filing Requirements
Illinois does not require NPs to file the collaborative agreement itself with the board. The only filing obligation arises when controlled-substance prescribing is delegated: the collaborating physician must file notice of that delegation (and of any termination) with the Department and the Prescription Monitoring Program. There are no recurring filing requirements. NPs may practice as soon as the arrangement is in place, but an NP delegated controlled-substance authority must hold an Illinois controlled substance license before prescribing.
Source: 225 ILCS 65/65-40(c)
Do you have to file the collaborative agreement with the board in Illinois?
No, not the agreement itself. The only filing required is a physician’s notice of delegation to the Department and Prescription Monitoring Program, and only when controlled-substance prescribing is delegated.
Can an NP start practicing as soon as they file in Illinois?
Yes, provided any required credential is in place. An NP delegated controlled-substance prescribing must hold an Illinois controlled substance license before prescribing those medications.
What are the termination and notice requirements in Illinois?
The collaborating physician must file notice with the Department and Prescription Monitoring Program when controlled-substance prescribing delegation ends. An NP may continue practicing for up to 90 days after a collaborative agreement is terminated, provided they seek needed collaboration at a local hospital and refer patients beyond their training to another provider.
Collaboration Compliance
Illinois imposes ongoing obligations mainly where prescribing is involved. For prescribing, the collaborating physician must periodically review the NP’s medication orders; there is no fixed number of charts to review. Routine meetings are not required in general, but where the physician has delegated Schedule II prescribing, the NP must discuss the condition of any patient receiving a controlled substance with the delegating physician monthly. Illinois sets no separate recordkeeping-retention period for collaboration records.
Source: 225 ILCS 65/65-40(b)
How many charts must a collaborating physician review in Illinois?
There is no fixed number. Where prescribing is delegated, the collaborating physician must review the NP’s medication orders periodically.
How often must an NP and collaborating physician meet in Illinois?
Illinois sets no general meeting requirement. However, where Schedule II prescribing is delegated, the NP must discuss any patient receiving a controlled substance with the delegating physician monthly.
How long must collaboration records be kept in Illinois?
Illinois sets no specific retention period for collaboration records.
Prescribing Rules
Illinois NPs may prescribe legend (prescription) drugs and, where a physician delegates the authority, controlled substances. Any delegation of prescriptive authority for legend drugs should be written into the collaborative agreement; no separate form is filed for legend drugs. For controlled substances, the physician must delegate the authority and file notice with the Department and Prescription Monitoring Program, and the NP must hold an Illinois mid-level practitioner controlled substance license plus a federal DEA registration. Schedule II prescribing carries extra conditions.
Source: 225 ILCS 65/65-40(c), (d)
Can an NP prescribe controlled substances in Illinois?
Yes, when a collaborating physician delegates the authority. The NP must hold an Illinois mid-level practitioner controlled substance license and a federal DEA registration, and the physician must file notice of the delegation with the Department and Prescription Monitoring Program.
Can an NP prescribe Schedule II drugs in Illinois?
Yes, if specifically delegated and subject to conditions. Schedule II may be delegated only for medications taken orally, topically, or transdermally that the physician routinely prescribes; each prescription is limited to a 30-day supply with any continuation requiring the physician’s prior approval; and the NP must discuss affected patients with the physician monthly. Schedule II drugs delivered by injection or other routes may not be delegated.
What schedule drugs can an NP prescribe in Illinois?
Illinois NPs may prescribe legend (non-controlled) drugs, and — when delegated by a collaborating physician — Schedule III through V controlled substances, and Schedule II controlled substances under the additional oral/topical/transdermal and 30-day-supply conditions.
Does an NP need a DEA license in Illinois?
Yes, to prescribe controlled substances. An NP delegated controlled-substance authority must hold an Illinois mid-level practitioner controlled substance license along with a federal DEA registration.
Can an NP prescribe independently in Illinois?
It depends on the NP’s status. An NP practicing under a collaborative agreement prescribes controlled substances only through the physician’s delegation, and Schedule II continuations require the physician’s prior approval; an NP with full practice authority is no longer tied to a collaborating physician.
Specialty & Telehealth Requirements
Illinois sets no telehealth-specific collaboration requirements for NPs, but it does have separate rules for certain collaborating professionals. Collaborative agreements with a podiatric physician, a dentist, or an anesthesiologist follow separate statutory subsections.
Source: 225 ILCS 65/65-35(b)
Are there telehealth or telemedicine requirements for NPs in Illinois?
No. Illinois sets no telehealth-specific collaboration requirement for NPs.
Are there specialty-specific requirements for NPs in Illinois?
Yes, based on the type of collaborating professional. Collaborative agreements with a podiatric physician, a dentist, or an anesthesiologist are governed by separate statutory subsections.
How do you verify a collaborating physician’s license in Illinois?
Illinois sets no specific requirement in the collaboration rules for how to verify a collaborating physician’s license.
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