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ORCHARD MEDICAL CENTER SC
NPI 1306835491
Family Medicine in Antioch, IL

Active since October 20, 2005CLIA 14D0411378 · Accreditation
543 ORCHARD ST, ORCHARD MEDICAL CENTER SC, ANTIOCH, IL 60002(847) 395-3322(847) 395-0921 Get Directions Write a Review

NPPES record last updated: December 11, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Orchard Medical Center Sc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ORCHARD MEDICAL CENTER SC (NPI 1306835491) is a healthcare organization registered as a family medicine in Antioch, Illinois and active in the NPI registry since October 2005. The organization holds an CLIA Accreditation certificate valid through December 22, 2027 and lists Ashley Matus, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1306835491
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameORCHARD MEDICAL CENTER SC
Location Address543 ORCHARD ST, ORCHARD MEDICAL CENTER SCAntioch, IL 60002-3107
Mailing Address543 Orchard St Orchard Medical Center ScAntioch, IL 60002-3107 · (847) 395-3322 · Fax (847) 395-0921
Phone(847) 395-3322
Fax(847) 395-0921
Organization SubpartNo
Authorized OfficialAshley MatusPractice Administrator · (847) 395-3322
Enumeration DateOctober 20, 2005
Last NPPES UpdateDecember 11, 2019
✔ NPI 1306835491 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
543 ORCHARD ST, Antioch, IL 60002
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Other Identifiers 1

Medicaid637760IL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Orchard Medical Center Sc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Orchard Medical Center Sc, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.

Clinicians, nearest first (5)

Guy Abderholden, MD
Family Practice
NPI 1902899792
543 ORCHARD ST
Antioch, IL 60002
(847) 395-3322
✔ PECOS✔ Accepts MedicareSame address
John Devaney, MD
Family Practice
NPI 1538152327
543 ORCHARD ST
Antioch, IL 60002
(847) 395-3322
✔ PECOS✔ Accepts MedicareSame address
Raquel Mejos, FNP-C
Nurse Practitioner
NPI 1114516754
543 ORCHARD ST
Antioch, IL 60002
(847) 395-3322
✔ PECOS✔ Accepts MedicareSame address
Elizabeth Soifer, DO
Family Practice
NPI 1184843328
543 ORCHARD ST
Antioch, IL 60002
(847) 395-3322
✔ PECOS✔ Accepts MedicareSame address
Sophie Huang, MD
Family Practice
NPI 1386264653
815 MAIN ST STE C
Peoria, IL 61602
(309) 672-4977
✔ PECOS✔ Accepts Medicare145 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 14D0411378

Orchard Medical Center · Antioch, IL
Active · expires Dec 22, 2027
CLIA Number14D0411378
Laboratory TypePhysician Office
Certificate Effective DateDecember 23, 2025
Certificate Expiration DateDecember 22, 2027
Laboratory DirectorGuy Abderholden
Laboratory Phone(847) 395-3322
Laboratory LocationOrchard Medical Center543 Orchard, Antioch, IL 60002
CLIA data matches this NPI record on: Address Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Orchard Medical Center Sc's NPI number?

The NPI number for Orchard Medical Center Sc is 1306835491. It was assigned to this organization in the NPPES registry on October 20, 2005.

Where is Orchard Medical Center Sc located?

Orchard Medical Center Sc is located at 543 Orchard St Orchard Medical Center Sc, Antioch, IL 60002. The listed phone number is (847) 395-3322.

What is Orchard Medical Center Sc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Orchard Medical Center Sc enrolled in Medicare?

Yes. Orchard Medical Center Sc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Orchard Medical Center Sc?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Orchard Medical Center Sc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Family Practice (4) and Nurse Practitioner (1). Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Orchard Medical Center Sc hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 14D0411378) is associated with this NPI, valid through December 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Orchard Medical Center Sc was last updated on December 11, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.