Join Our Network

Molina Healthcare of Illinois provider networkThank you for your interest in joining Molina Healthcare of Illinois' provider network. We currently provide coverage to HealthChoice Illinois (Medicaid), MLTSS, Medicare-Medicaid Program (Dual Options), and Marketplace members in the state of Illinois. Contracted providers are an essential part of delivering quality care to our members, and we value our partnerships with our providers.

Note: To join Molina Healthcare of Illinois' network, you must be enrolled as an Illinois Medicaid provider and have an active Medicaid ID number.


  • Step Two - Documentation

    If your Contract Request Form is accepted, our Provider Network Management team will provide you with contracting documents that must be completed. Documents you receive may differ depending on provider type, and may include:

    • - Provider Agreement
    • - Provider Information Form
    • - Ownership and Control Disclosure Form
    • - W-9
    • - Practitioner Application (if practitioner does not have an updated and attested CAQH profile)
    • - IAMHP Universal Roster

    Find these documents on our Frequently Used Forms page. Upon receipt of completed documents, Provider Network Management will then begin the network enrollment process.


Already a participating provider but would like to join an existing participating group? Please complete a Provider Information Update Form and submit to

Adding a Provider to a Participating Group? Please complete a Provider Information Update Form and submit to