Individual provider Active NPI

Nicole Marie Padilla, M.D.

  • Family Medicine Physician
  • West Dundee, IL
National Provider Identifier
1457791741
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036140735 Issued in IL
Practice address
1925 Huntley Rd
West Dundee, IL 60118
Phone
(815) 338-6600
Fax
(847) 426-5162
NPI assigned
Jul 1, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 125064024 IL
Hospitalist Physician 208M00000X 036140735 IL
Family Medicine Physician 207Q00000X 036140735 IL Primary

Addresses

Primary practice location

1925 Huntley Rd
West Dundee, IL 60118

Mailing address

360 Station Dr
Crystal Lake, IL 60014-7978
Phone (815) 338-6600

Other practice location 1

2233 W Division St
Chicago, IL 60622-8151
Phone (951) 961-1186

Other practice location 2

1423 Chicago Rd
Chicago Heights, IL 60411-3400
Phone (708) 679-2160

Other practice location 3

360 Station Dr
Crystal Lake, IL 60014-7978
Phone (815) 338-6600

Other practice location 4

2507 N Richmond Rd
McHenry, IL 60051-5407
Phone (815) 338-6600

Other practice location 5

10350 Haligus Rd
Huntley, IL 60142-9545
Phone (815) 338-6600

Other practice location 6

20201 Crawford Ave
Olympia Fields, IL 60461-1010
Phone (708) 679-2160

Other practice location 7

40 75th St
Willowbrook, IL 60527-2325
Phone (630) 405-8892

Other identifiers 1

IdentifierTypeStateIssuer
036140735OtherILSTATE LICENSE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160912002730 IL Practitioner - Family PracticePractitioner - Peripheral Vascular Disease 2163712597 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Peripheral Vascular Disease
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vohra Wound Physicians of Il SCGroup PAC ID 9830377688, 20 clinicians

Practice addresses (Care Compare)

7370 W Talcott Ave
Chicago, IL 60631-3751
Phone (877) 866-7123

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1511
Removal of skin lesions74
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125064024ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Family Medicine CurrentSince May 1, 2019 Accepting new patients
Cook County Family Medicine CurrentSince Mar 13, 2024 Accepting new patients
Midwest Express Care 2, Inc Family Medicine CurrentSince Nov 1, 2021 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince May 1, 2019 Accepting new patients
Community First Healthcare of Illinois, Inc. CurrentSince Jun 19, 2018 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Nov 1, 2021 Accepting new patients
Community First Healthcare of Illinois, Inc. CurrentSince Jun 19, 2018 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince May 1, 2019 Accepting new patients
Cook County CurrentSince Mar 13, 2024 Accepting new patients
Vohra Wound Physicians of Il, S.C. Family Medicine CurrentSince Mar 4, 2019 Accepting new patients
Cook County Current Accepting new patients
Central Dupage Physician Group CurrentSince May 1, 2019 Accepting new patients

Locations

3601 SW 160th Ave
Ste 250
Miramar, FL 33027
Phone (305) 866-9951

12200 Western Ave
Blue Island, IL 60406
Phone (630) 581-5372

Dept 5777
Carol Stream, IL 60122

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

5645 W Addison St
Chicago, IL 60634
Phone (773) 282-7000

7370 W Talcott Ave
Chicago, IL 60631
Phone (312) 783-3348

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

5645 W Addison St
Ste 301
Chicago, IL 60634
Phone (773) 736-4553

360 Station Dr
Ste 150
Crystal Lake, IL 60014

360 Station Dr
Crystal Lake, IL 60014
Phone (815) 477-7350

11650 S State Route 47
Huntley, IL 60142
Phone (847) 802-7300

10350 Haligus Rd
Huntley, IL 60142
Phone (847) 802-7150

10350 Haligus Rd
Ste 120
Huntley, IL 60142
Phone (815) 356-2323

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

2507 N Richmond Rd
McHenry, IL 60051
Phone (815) 363-2350

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

1925 Huntley Rd
West Dundee, IL 60118
Phone (847) 854-3421

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

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2474/brand/3/csg/81/fhir/r4

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1457791741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 STATION DR",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147978",
            "telephone_number": "815-338-6600",
            "fax_number": "815-426-5162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 HUNTLEY RD",
            "city": "WEST DUNDEE",
            "state": "IL",
            "postal_code": "60118",
            "telephone_number": "815-338-6600",
            "fax_number": "847-426-5162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2233 W Division St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606228151",
            "country_code": "US",
            "telephone_number": "951-961-1186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1423 Chicago Rd",
            "address_purpose": "LOCATION",
            "city": "Chicago Heights",
            "state": "IL",
            "postal_code": "604113400",
            "country_code": "US",
            "telephone_number": "708-679-2160",
            "fax_number": "708-679-2161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "360 Station Dr",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600147978",
            "country_code": "US",
            "telephone_number": "815-338-6600",
            "fax_number": "815-426-5162",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2507 N Richmond Rd",
            "address_purpose": "LOCATION",
            "city": "McHenry",
            "state": "IL",
            "postal_code": "600515407",
            "country_code": "US",
            "telephone_number": "815-338-6600",
            "fax_number": "815-385-3255",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10350 Haligus Rd",
            "address_purpose": "LOCATION",
            "city": "Huntley",
            "state": "IL",
            "postal_code": "601429545",
            "country_code": "US",
            "telephone_number": "815-338-6600",
            "fax_number": "847-802-7112",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20201 Crawford Ave",
            "address_purpose": "LOCATION",
            "city": "Olympia Fields",
            "state": "IL",
            "postal_code": "604611010",
            "country_code": "US",
            "telephone_number": "708-679-2160",
            "fax_number": "708-679-2161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "40 75th St",
            "address_purpose": "LOCATION",
            "city": "Willowbrook",
            "state": "IL",
            "postal_code": "605272325",
            "country_code": "US",
            "telephone_number": "630-405-8892",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PADILLA",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-01",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125064024",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036140735",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036140735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036140735",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Dundee, IL

Sources for this page

Verify at the official NPI Registry.