Active NPI
Maddalena Fairchild
- Physician Assistant
- Roanoke, IL
National Provider Identifier
1790644383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085.011960
- Practice address
- 401 N Main St
Roanoke, IL 61561-7585 - Phone
- (309) 923-2661
- NPI assigned
- Jan 19, 2026
- Last updated
- Jan 19, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085.011960 | IL | Primary |
Addresses
Primary practice location
401 N Main St
Roanoke, IL 61561-7585
Mailing address
2970 Briarwood LN
Titusville, FL 32796-1689
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
124 SW Adams St
Peoria, IL 61602-1308
6339 N Big Hollow Rd
Peoria, IL 61615-2932
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085.011960 | IL | MD | Physician Assistant |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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- Peoria, IL
- NPI 1922445527
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dba OSF Saint Elizabeth Medical Center
- General Acute Care Hospital
- Ottawa, IL
- NPI 1306971080
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1768780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768780800000",
"number": "1790644383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2970 BRIARWOOD LN",
"city": "TITUSVILLE",
"state": "FL",
"postal_code": "327961689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 N MAIN ST",
"city": "ROANOKE",
"state": "IL",
"postal_code": "615617585",
"telephone_number": "309-923-2661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIRCHILD",
"first_name": "MADDALENA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-01-19",
"last_updated": "2026-01-19",
"certification_date": "2026-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085.011960",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roanoke, IL
- County of Woodford Village of Roanoke (Roanoke Municipal Ambulance)
- Megan Elizabeth Cox
- Steven Lee Crawford, R. PH.
- Maddalena Davenport, APRN
- Paige Alexandria Dylewski, APRN
- Karagen Grace Fandel, APRN, FNP-C
- Teresa Finegan, APRN
- Petra Flores, APRN, FNP-C
- Victoria Gorfin, PA-C
- Renee Elizabeth Hemp, APRN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.