DR. MADISON MCKENZIE MD
NPI 1790679439
Student in an Organized Health Care Education/Training Program in Rockford, IL
About Dr. Madison Mckenzie Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. MADISON MCKENZIE MD (NPI 1790679439) is an individual student in an organized health care education/training program in Rockford, Illinois, licensed in Illinois (125086384) and active in the NPI registry since June 2025. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Madison Mckenzie Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ROCKFORD, IL 61104
ROCKFORD, IL 61104
ROCKFORD, IL 61104
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 Madison Mckenzie's NPI number?
The NPI number for Madison Mckenzie is 1790679439. It was assigned to this individual provider in the NPPES registry on June 6, 2025. The provider is also known as Dr. Madison Mckenzie MD.
Where is Madison Mckenzie located?
Madison Mckenzie practices at 1221 E State St, Rockford, IL 61104. The listed phone number is (815) 972-1037.
What is Madison Mckenzie's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Madison Mckenzie enrolled in Medicare?
Yes. Madison Mckenzie is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Madison Mckenzie was last updated on September 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.
# Dr. Madison Mckenzie, MD · NPI 1790679439
Student in an Organized Health Care Education/Training Program provider in Rockford, Illinois. Individual provider, active in the CMS NPPES registry since June 6, 2025.
## Identity
- **NPI:** 1790679439 (Entity type: Individual)
- **Enumerated:** June 6, 2025
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **State license:** 125086384 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 1221 E STATE ST, Rockford, IL 61104-2231
- **Phone:** (815) 972-1037
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** September 22, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1790679439) · Data from the CMS NPPES public registry.