Individual provider Active NPI

Alison Jean Drerup

  • Family Nurse Practitioner
  • Rockford, IL
National Provider Identifier
1083397418
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209-030605 Issued in IL
Practice address
3505 N Bell School Rd
Rockford, IL 61114-6624
Phone
(779) 696-0300
Fax
(815) 639-9433
NPI assigned
Aug 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041529173 IL
Inpatient Obstetric Registered Nurse 163WX0003X 2018020114 MO
Family Nurse Practitioner 363LF0000X 209-030605 IL Primary

Addresses

Primary practice location

3505 N Bell School Rd
Rockford, IL 61114-6624

Mailing address

4429 Southview Way Dr
Saint Louis, MO 63129-6718
Phone (815) 988-2852

Other practice location 1

1015 Bowles Ave
Fenton, MO 63026-2394
Phone (636) 496-2000

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
I20241115004075 IL Practitioner - Nurse Practitioner 2466986161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedishamerican HospitalGroup PAC ID 5799698346, 386 clinicians

Practice addresses (Care Compare)

3505 N Bell School Rd
Rockford, IL 61114-6624
Phone (779) 696-0300

Hospital & facility affiliations

  • Uw Health Hospital, Rockford, IL, CCN 140228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041529173ILMDRegistered Nurse
2018020114MOMDInpatient Obstetric Registered Nurse
209-030605ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Swedishamerican Hospital Family CurrentSince Oct 3, 2024 Accepting new patients
Swedishamerican Hospital Current Accepting new patients
Swedishamerican Hospital CurrentSince Oct 3, 2024 Accepting new patients

Locations

3505 N Bell School Rd
Rockford, IL 61114
Phone (779) 696-0300

6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610

2550 Charles St
Rockford, IL 61108
Phone (779) 696-7285

Organizations & group practices 3

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 1

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": "1691712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1083397418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4429 SOUTHVIEW WAY DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631296718",
            "telephone_number": "815-988-2852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 N BELL SCHOOL RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611146624",
            "telephone_number": "779-696-0300",
            "fax_number": "815-639-9433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1015 Bowles Ave",
            "address_purpose": "LOCATION",
            "city": "Fenton",
            "state": "MO",
            "postal_code": "630262394",
            "country_code": "US",
            "telephone_number": "636-496-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DRERUP",
        "first_name": "ALISON",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-11",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041529173",
            "primary": false
        },
        {
            "code": "163WX0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Obstetric, Inpatient",
            "state": "MO",
            "license": "2018020114",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209-030605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.