Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Madison Nicole Petersen, PA-C

Individual provider Physician Assistant · NPI 1467288043

Madison Nicole Petersen, PA-C is a Physician Assistant in Chicago, Illinois. Qualified in 2024, 2 years ago. Practices with Jordan C Carqueville MD LLC, a 10-clinician group, works from 3 locations and accepts Medicare assignment.

Years since qualifying
2
In the registry since
2024
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

737 N Michigan Ave Ste 720
Chicago, IL 60611-6661
Phone: (312) 319-1978
Fax: (312) 262-7791
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1945 W Wilson Ave Ste 6119, Chicago, IL 60640-5259 — (312) 319-1978
  • 920 N York Rd Ste 100, Hinsdale, IL 60521-3515 — (312) 319-1978

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1467288043
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 11, 2024
Last updated in NPPESJanuary 11, 2025
Certification dateJanuary 11, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Jordan C Carqueville Md Llc — 10 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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