SAINT ANTHONY MEDICAL CENTER (NPI# 1164475059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164475059 |
| Entity Type | Organization |
| Organization Name | SAINT ANTHONY MEDICAL CENTER |
| Other Organization Name | OSFMG - WILLOWCREEK |
| Practice Address |
9721 N Alpine Rd Machesney Park IL 61115-1664 |
| Mailing Address |
Po Box 1712 Peoria IL 61656-1712 |
| Practice Telephone | 8005896070 |
| Practice Fax Number | 3096835969 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2007-08-17 |
| Authorized Official Name | DR. GERALD J. MCSHANE (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 3096557193 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | OSF HEALTHCARE SYSTEM |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS | 10123444 | 01 |
| Other Name | Type Code |
|---|---|
| OSFMG - Willowcreek | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023051992 | Saint Anthony Medical Center | Home Health | 5501 E State St, Rockford, IL 61108-2338 | 2006-06-14 |
| 1669428702 | Saint Anthony Medical Center | Internal Medicine | 5713 Strathmoor Dr, Rockford, IL 61107-7093 | 2006-05-26 |
| 1952356040 | Saint Anthony Medical Center | Physician Assistant | 6830 Villagreen Vw, Rockford, IL 61107-5639 | 2006-05-24 |
| 1003869967 | Saint Anthony Medical Center | Pediatrics | 556 E Grant Hwy, Marengo, IL 60152-3346 | 2006-05-19 |
| 1235182288 | Saint Anthony Medical Center | Family Medicine | 143 Kishwaukee St, Belvidere, IL 61008-3507 | 2006-05-19 |
| 1225378722 | Saint Anthony Medical Center | Rehabilitation Unit | 5510 E State St, Rockford, IL 61108-2381 | 2013-02-20 |
| 1871860056 | Saint Anthony Medical Center | Neurological Surgery | 535 Roxbury Rd, Rockford, IL 61107-5076 | 2011-11-16 |
| 1265688766 | Saint Anthony Medical Center | Internal Medicine | 9951 Rock Cut Crossing, Loves Park, IL 61111 | 2008-08-15 |
| 1730335266 | Saint Anthony Medical Center | Internal Medicine | 9951 Rock Cut Crossing, Loves Park, IL 61111 | 2008-08-15 |
| 1952573222 | Saint Anthony Medical Center | Internal Medicine | 9951 Rock Cut Crossing, Loves Park, IL 61111-3609 | 2008-03-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SAINT ANTHONY MEDICAL CENTER | 6368 Hollywood Blvd, Los Angeles, CA 90028-6320 |
| Street Address |
9721 N ALPINE RD |
| City | MACHESNEY PARK |
| State | IL |
| Zip Code | 61115-1664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710174248 | Brittany N Frisella | Nurse Practitioner | 9721 N Alpine Rd, Machesney Park, IL 61115-1664 | 2007-09-28 |
| 1114956091 | Cornerstone Clinic, Ltd. | Obstetrics & Gynecology | 9721 N Alpine Rd, Machesney Park, IL 61115-1664 | 2006-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033675087 | Mary B O'meara | Nurse Practitioner | 9721 N Alpine, Machesney Park, IL 61115 | 2019-02-14 |
| 1518486398 | Jordyn Morris | Speech-Language Pathologist | 710 Ralston Rd, Machesney Park, IL 61115 | 2017-09-13 |
| 1053713966 | Dental Professionals of Illinois, P.C. | Dentist | 1411 W Lane Rd Ste B, Machesney Park, IL 61115 | 2014-09-23 |
| 1922326271 | Mitalkumar K Patel | Dentist | 1363 W. Lane Road, Machesney Park, IL 61115 | 2010-05-12 |
| 1720134802 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 1349 W Lane Rd, Machesney Park, IL 61115 | 2007-01-25 |
| 1710371471 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 1770 W Lane Rd, Machesney, IL 61115 | 2015-03-20 |
| 1225436546 | Susan Lynn Sherbon | Community/Behavioral Health | 251 Brentwood Rd, Machesney Park, IL 61115-1064 | 2014-12-18 |
| 1174872519 | Dana Lynn Slabaugh | Physical Therapist | 10510 Ventura Blvd, Machesney Park, IL 61115-1263 | 2012-08-30 |
| 1073590204 | Terry Buzzard | Family Medicine | 11475 N 2nd St, Machesney Park, IL 61115-1285 | 2005-12-29 |
| 1609475672 | Meaghan Elizabeth Reed | Physician Assistant | 11475 N 2nd St, Machesney Park, IL 61115-1285 | 2020-10-21 |
| Find all providers in zip 61115 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073590204 | Terry Buzzard | Family Medicine | 11475 N 2nd St, Machesney Park, IL 61115-1285 | 2005-12-29 |
| 1427035534 | Lawrence Nelson | Family Medicine | 8103 Burden Rd, Machesney Park, IL 61115-8208 | 2005-12-29 |
| 1487687810 | Philip Sudchart Benjakul | Family Medicine | 10100 Forest Hills Rd, Machesney Park, IL 61115-8234 | 2006-07-09 |
| 1356328363 | Joshua Newman | Family Medicine | 11475 N 2nd St, Machesney Park, IL 61115-1285 | 2005-12-30 |
| 1215914320 | John Stranig | Family Medicine | 11475 N 2nd St, Machesney Park, IL 61115-1285 | 2005-12-29 |
| 1063499101 | Terry Strawser | Family Medicine | 11475 N 2nd St, Machesney Park, IL 61115-1285 | 2005-12-29 |
| 1326025586 | Jon Price | Family Medicine | 11475 N 2nd St, Machesney Park, IL 61115-1285 | 2005-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053911495 | Moataz Barkat | Family Medicine | 3315 W 66th Pl, Chicago, IL 60629-3427 | 2020-10-26 |
| 1558969964 | Nicole Kerner | Family Medicine | 310 Brandy Dr, Mackinaw, IL 61755-9707 | 2020-10-16 |
| 1285232991 | Healthy Medical Inc | Family Medicine | 535 N. East St., Suite A, Bradley, IL 60915 | 2020-10-14 |
| 1558976589 | Jasmine Ashley Fowler | Family Medicine | 2416 N Lotus Ave, Chicago, IL 60639-1435 | 2020-09-15 |
| 1790390805 | Kimberly Hannah Kupferberg | Family Medicine | 1103 Schaeffer Rd, Long Grove, IL 60047-5153 | 2020-09-15 |
| 1194330977 | Home Doctors for You | Family Medicine | 670 Illinois Blvd, Hoffman Est, IL 60169-3363 | 2020-09-09 |
| 1245844489 | Jovita Zalwango Nassolo | Family Medicine | 116 1/2 N Benton St Apt 2d, Woodstock, IL 60098-3272 | 2020-09-04 |
| 1720699176 | Healing Hands Resource Center Streator | Family Medicine | 2128 S Central Park Ave, Chicago, IL 60623-3113 | 2020-08-10 |
| 1417565755 | Ghr Total Health and Consulting | Family Medicine | 11336 Mckenna Dr, Frankfort, IL 60423-8096 | 2020-07-22 |
| 1285251892 | Soe Lwin Oo | Family Medicine | 1625 E 75th St # 1, Chicago, IL 60649-3603 | 2020-06-30 |
| Find all providers with the same taxonomy | ||||
| City | MACHESNEY PARK |
| Zip Code | 61115 |
Please comment or provide details below to improve the information on SAINT ANTHONY MEDICAL CENTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.