Individual provider Active NPI

Madison Soderstrum, FNP-BC

  • Family Nurse Practitioner
  • Joliet, IL
National Provider Identifier
1316550171
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.021710 Issued in IL
Practice address
2025 S Chicago St
Joliet, IL 60436-3172
Phone
(815) 726-2200
NPI assigned
Aug 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.021710 IL Primary

Addresses

Primary practice location

2025 S Chicago St
Joliet, IL 60436-3172

Mailing address

2025 S Chicago St
Joliet, IL 60436-3172
Phone (815) 726-2200

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
I20201016000099 IL Practitioner - Nurse Practitioner 7214357094 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Care Physicians of Joliet SCGroup PAC ID 5193078095, 18 clinicians

Practice addresses (Care Compare)

2025 S Chicago St
Suite 1
Joliet, IL 60436-3173
Phone (815) 726-2200

Hospital & facility affiliations

  • Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.021710ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Clinical LLC Family CurrentSince Sep 15, 2020 Accepting new patients
Primary Care Physicians of Joliet SC CurrentSince Nov 1, 2021 Accepting new patients
Osf Multi-Specialty Group Past Accepting new patients
Oak Street Health Physicians Group, PC Family Past Accepting new patients
Paragon Clinical Midwest, LLC Past Accepting new patients

Locations

745 McClintock Dr
Ste 360
Burr Ridge, IL 60527
Phone (630) 506-1245

1333 Burr Ridge Pkwy
Ste 200
Burr Ridge, IL 60527
Phone (630) 308-8706

2025 S Chicago St
Joliet, IL 60436
Phone (815) 726-2200

2025 S Chicago St
Ste B
Joliet, IL 60436
Phone (815) 947-4174

2025 S Chicago St
Ste 1
Joliet, IL 60436
Phone (815) 726-2200

14601 John Humphrey Dr
Orland Park, IL 60462
Phone (708) 349-8300

121 Winchester Green Dr
Wilmington, IL 60481
Phone (815) 286-8487

Organizations & group practices 5

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 2

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": "1598745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1316550171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 S CHICAGO ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604363172",
            "telephone_number": "815-726-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 S CHICAGO ST",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604363172",
            "telephone_number": "815-726-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODERSTRUM",
        "first_name": "MADISON",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-30",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.021710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.