Healthcare Provider Details

I. General information

NPI: 1932040151
Provider Name (Legal Business Name): JOHN MACHADO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 JOHN DEERE PL
MOLINE IL
61265-8010
US

IV. Provider business mailing address

4805 PRIME PKWY
MCHENRY IL
60050-7002
US

V. Phone/Fax

Practice location:
  • Phone: 815-363-9500
  • Fax:
Mailing address:
  • Phone: 815-363-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036.178983
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: