Marisa Medina, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

277001697 Issued in IL

Practice address

24735 W Eames St Unit 10
Channahon, IL 60410-8712

Phone

(815) 200-6993

NPI assigned

Mar 26, 2019

Last updated

Oct 16, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Marisa Ruiz Former name

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Will County Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Joliet, IL
  • NPI 1902811714
  Medicare reassignment NPD
• Will County Community Health Center

  dba Will County Community Health Center East

  • Federally Qualified Health Center (FQHC)
  • Monee, IL
  • NPI 1053870204
  NPD
• Will County Community Health Center

  dba Will County Community Health Center North

  • Federally Qualified Health Center (FQHC)
  • Bolingbrook, IL
  • NPI 1346772373
  NPD

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792108800000",
    "number": "1891256517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24735 W EAMES ST UNIT 10",
            "city": "CHANNAHON",
            "state": "IL",
            "postal_code": "604108712",
            "telephone_number": "815-200-6993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24735 W EAMES ST UNIT 10",
            "city": "CHANNAHON",
            "state": "IL",
            "postal_code": "604108712",
            "telephone_number": "815-200-6993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "MARISA",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2026-10-16",
        "certification_date": "2026-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277001697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISA",
            "last_name": "RUIZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marathon Health, LLC (UWC-Channahon)
• Marathon Health, LLC (Uwc- Channahon)
• Joan M. McAtee, PT
• Tedd W. McCauley, MSSA
• Renee A McIlheran
• Kelly Melzer McHale
• Isaac Mezo, M.D.
• Milestones Matter, Inc
• Christopher W. Miller, APN-CNP
• Minor Chiropractic Health Center PC

• Family Nurse Practitioner in Channahon, IL
• Providers in Channahon, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.