Orchard Medical Center SC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ORCHARD MEDICAL CENTER SC

Practice address

543 Orchard St
Orchard Medical Center SC
Antioch, IL 60002-3107

Phone

(847) 395-3322

Fax

(847) 395-0921

NPI assigned

Oct 20, 2005

Last updated

Dec 11, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ashley Matus

Title

Practice Administrator

Phone

(847) 395-3322

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Guy R Abderholden, MD

  • Family Medicine Physician
  • Antioch, IL
  • NPI 1902899792
  Medicare reassignment Care Compare group NPD
• John J Devaney Jr., MD

  • Family Medicine Physician
  • Antioch, IL
  • NPI 1538152327
  Medicare reassignment Care Compare group NPD
• Sophie Huang, MD

  • Family Medicine Physician
  • Peoria, IL
  • NPI 1386264653
  Medicare reassignment Care Compare group NPD
• Elizabeth Soifer, DO

  • Family Medicine Physician
  • Antioch, IL
  • NPI 1184843328
  Medicare reassignment Care Compare group
• Raquel G Mejos, FNP-C

  • Family Nurse Practitioner
  • Antioch, IL
  • NPI 1114516754
  Medicare reassignment NPD
• Briana Elizabeth Aiken, PA

  • Physician Assistant
  • Antioch, IL
  • NPI 1649506874
  Medicare reassignment
• Theodore Voss Holroyd, PA

  • Physician Assistant
  • Antioch, IL
  • NPI 1467670901
  NPD (past)

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576022400000",
    "number": "1306835491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "543 ORCHARD ST ORCHARD MEDICAL CENTER SC",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600023107",
            "telephone_number": "847-395-3322",
            "fax_number": "847-395-0921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "543 ORCHARD ST",
            "address_2": "ORCHARD MEDICAL CENTER SC",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600023107",
            "telephone_number": "847-395-3322",
            "fax_number": "847-395-0921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORCHARD MEDICAL CENTER SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-20",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A",
        "authorized_official_last_name": "MATUS",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "847-395-3322"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "637760",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Newpath Vital RX Inc.
• Berta Newton, OD
• James Novacek, LCSW
• Lena Ochoa
• Oneopto Il 1 PLLC (Antioch Eyecare)
• Gavin J Patterson, PT, DPT
• Angela Sue Peters, NURSE PRACTITIONER A
• Positive Pathways
• Jessica L Quirini
• Janet Racina

• Family Medicine Physician in Antioch, IL
• Providers in Antioch, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.