SAINT ANTHONY MEDICAL CENTER (NPI# 1952356040) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952356040 |
| Entity Type | Organization |
| Organization Name | SAINT ANTHONY MEDICAL CENTER |
| Other Organization Name | OSFMG - SPRINGCREEK |
| Practice Address |
6830 Villagreen Vw Rockford IL 61107-5639 |
| Mailing Address |
Po Box 1712 Peoria IL 61656-1712 |
| Practice Telephone | 8005896070 |
| Practice Fax Number | 3096835969 |
| Enumeration Date | 2006-05-24 |
| 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 | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | 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 - Springcreek | 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 |
| 1003869967 | Saint Anthony Medical Center | Pediatrics | 556 E Grant Hwy, Marengo, IL 60152-3346 | 2006-05-19 |
| 1164475059 | Saint Anthony Medical Center | Nurse Practitioner | 9721 N Alpine Rd, Machesney Park, IL 61115-1664 | 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 |
6830 VILLAGREEN VW |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61107-5639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023533122 | Wendy Demler | Nurse Practitioner | 6830 Villagreen Vw, Rockford, IL 61107-5639 | 2017-08-09 |
| 1003029224 | Ellissa A Schwartz | Physician Assistant | 6830 Villagreen Vw, Rockford, IL 61107-5639 | 2007-05-07 |
| 1285668723 | Christine Elizabeth Larson | Physician Assistant | 6830 Villagreen Vw, Rockford, IL 61107-5639 | 2006-07-10 |
| 1578596227 | Diane Helen Zug | Family Medicine | 6830 Villagreen Vw, Rockford, IL 61107-5639 | 2006-07-08 |
| 1265464895 | Mark John Schneider | Internal Medicine | 6830 Villagreen Vw, Rockford, IL 61107-5639 | 2006-07-06 |
| 1588693626 | William Eric Kobler | Family Medicine | 6830 Villagreen Vw, Rockford, IL 61107-5639 | 2006-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356952139 | Jessica Marie Tamayo Fernandez | Pharmacist | 1145 Alpine Rd, Rockford, IL 61107 | 2020-08-13 |
| 1467092379 | Unknown Safa Fatima | Student in an Organized Health Care Education/Training Program | Mercyhealth Mulford Clinic, 5970 Churchview Drive, Rockford, IL 61107 | 2020-01-08 |
| 1194367912 | Matt J Kriebs | Nurse Practitioner | 1235 N Mulford Rd Suite 103, Rockford, IL 61107 | 2019-10-14 |
| 1265962336 | Mary Golembeck | Nurse Practitioner | 7290 Argus Dr, Rockford, IL 61107 | 2017-06-12 |
| 1831644749 | Tessa Lee | Occupational Therapist | 3422 Lauderdale Ln, Rockford, IL 61107 | 2016-08-20 |
| 1942626965 | Elevated Health Essentials, LLC | Chiropractor | 124 N Water St Ste 204e, Rockford, IL 61107 | 2014-03-14 |
| 1093139909 | Swedishamerican Hospital | Surgery | 1639 N Alpine Rd Ste 400, Rockford, IL 61107 | 2014-02-12 |
| 1346676582 | Christopher Anthony Ziganto | Pharmacist | 494 Bienterra Trail #2, Rockford, IL 61107 | 2013-09-19 |
| 1023358272 | Lavanya Durairajan | Physical Therapist | 7358 Shiligton Dr, Rockford, IL 61107 | 2013-02-26 |
| 1851523146 | Great Smiles of Rockford | Durable Medical Equipment & Medical Supplies | 780 N. Mulfrord Road, Rockford, IL 61107 | 2009-08-20 |
| Find all providers in zip 61107 | ||||
| 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 |
|---|---|---|---|---|
| 1851910350 | Charity L Soles | Family Medicine | 4134 Ashwinton Way, Rockford, IL 61109-3273 | 2020-04-14 |
| 1306250543 | Camille Ryan | Family Medicine | 6050 Northland Dr Ne Ste 200, Rockford, MI 49341-9257 | 2014-06-16 |
| 1396991485 | Novella Ann Schafer | Family Medicine | 3719 Regal Ridge Circle, Rockford, IL 61114-6037 | 2008-08-08 |
| 1417139130 | Derek Lanier | Family Medicine | 8450 Brower Lake Rd Ne, Apt/suite, Rockford, MI 49341-9346 | 2007-12-04 |
| 1144414921 | Moses Godofredo Tomacruz | Family Medicine | 1502 Parkview Ave, Rockford, IL 61107-1821 | 2007-09-05 |
| 1508077165 | Robert Dejonge Do PC | Family Medicine | 350 Northland Dr Ne, Rockford, MI 49341-1401 | 2007-05-25 |
| 1902018641 | Julie Stark | Family Medicine | 3475 So Alpine Rd, Physicians Immediate Care, Rockford, IL 61109-2604 | 2007-05-04 |
| 1205976024 | Mohammed Khaleeluddin | Family Medicine | 1729 Oak Park Drive, Rockford, IL 61107-5510 | 2007-02-08 |
| 1134273238 | Swedishamerican Hosptial | Family Medicine | 3906 N Main St, Suite A, Rockford, IL 61103-1679 | 2007-01-23 |
| 1194897223 | Niccole Ranz | Family Medicine | 2222 E State St, Suite 209, Rockford, IL 61104-1573 | 2006-11-14 |
| Find all providers in ROCKFORD | ||||
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| 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.