Individual provider Active NPI

Madison Carol Medina, PA-C

  • Physician Assistant
  • Orland Park, IL
National Provider Identifier
1093530362
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.011066 Issued in IL
Practice address
15300 West Ave Ste 100
Orland Park, IL 60462-4600
Phone
(708) 923-4400
Fax
(708) 590-6605
NPI assigned
Nov 20, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.011066 IL Primary

Addresses

Primary practice location

15300 West Ave Ste 100
Orland Park, IL 60462-4600

Mailing address

15300 West Ave Ste 100
Orland Park, IL 60462-4600
Phone (708) 923-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250212003150 IL Practitioner - Physician Assistant 1658801196 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

12251 S 80TH Ave
Palos Heights, IL 60463-1290

15300 W Ave
Orland Park, IL 60462-4600

15300 W Ave BLDG a
Suite 100
Orland Park, IL 60462-4600
Phone (708) 226-2626

1800 N Main St
Wheaton, IL 60187-3112
Phone (630) 933-4800

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.011066ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Apr 20, 2025 Accepting new patients
Central Dupage Physician Group CurrentSince Mar 2, 2025 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Apr 20, 2025 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

21202 Owens Rd
Ste 300
Mokena, IL 60448
Phone (779) 334-0010

15300 West Ave
Ste 100
Orland Park, IL 60462
Phone (708) 226-2500

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1732060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766102400000",
    "number": "1093530362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15300 WEST AVE STE 100",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624600",
            "telephone_number": "708-923-4400",
            "fax_number": "708-590-6605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15300 WEST AVE STE 100",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624600",
            "telephone_number": "708-923-4400",
            "fax_number": "708-590-6605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "MADISON",
        "middle_name": "CAROL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-20",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.011066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.