Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Amalia Maria Prodanovic

Individual provider Physician Assistant · NPI 1396235792

Amalia Maria Prodanovic is a Physician Assistant in Lake Forest, Illinois. Qualified in 2018, 8 years ago. Practices with Northwestern Medical Faculty Foundation, a 4,394-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
8
Licensed in
IL
In the registry since
2018
Specialties on file
3
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Practice location Address checks out

1000 N Westmoreland Rd
Lake Forest, IL 60045
Phone: (847) 234-5600
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 08500646 (IL)
Physician Assistant Taxonomy 363A00000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1396235792
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 11, 2018
Last updated in NPPESNovember 6, 2025
Certification dateNovember 6, 2025
Mailing address714 S Hamlin Ave, Park Ridge, IL 60068-4314

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Northwestern Medical Faculty Foundation — 4394 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

Other providers in Lake Forest