Individual provider Active NPI

Andrea M Shewalter, APRN

  • Family Nurse Practitioner
  • Rockford, IL
National Provider Identifier
1083180228
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2018017362 Issued in IL
Practice address
535 Roxbury Rd
Rockford, IL 61107-5076
Phone
(815) 387-1717
NPI assigned
Oct 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2018017362 IL Primary
Family Nurse Practitioner 363LF0000X 041351530 IL

Addresses

Primary practice location

535 Roxbury Rd
Rockford, IL 61107-5076

Mailing address

11189 Jasmine Dr
Roscoe, IL 61073-9410
Phone (815) 501-3115

Other practice location 1

1045 W Stephenson St
Freeport, IL 61032-4864
Phone (815) 599-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181217001667 IL Practitioner - Nurse Practitioner 7113262338 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

1010 Fairway Dr
Freeport, IL 61032-6600
Phone (815) 599-7421

2600 Compass Rd
Glenview, IL 60026-8001

535 Roxbury Rd
Rockford, IL 61107-5076
Phone (815) 387-1717

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041351530ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Freeport Regional Health Care Foundation CurrentSince Aug 25, 2025 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

1010 Fairway Dr
Freeport, IL 61032
Phone (815) 599-6340

1045 W Stephenson St
Freeport, IL 61032
Phone (815) 599-6105

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

600 N Rush St
Stockton, IL 61085
Phone (815) 235-3165

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1083180228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11189 JASMINE DR",
            "city": "ROSCOE",
            "state": "IL",
            "postal_code": "610739410",
            "telephone_number": "815-501-3115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075076",
            "telephone_number": "815-387-1717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1045 W Stephenson St",
            "address_purpose": "LOCATION",
            "city": "Freeport",
            "state": "IL",
            "postal_code": "610324864",
            "country_code": "US",
            "telephone_number": "815-599-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEWALTER",
        "first_name": "ANDREA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-15",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "2018017362",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "041351530",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.