NPIMap

Gundersen Lutheran Medical Center Inc

Organization Active NPI Clinic/Center · Rockford, IL

NPI 1215616628 · NPPES record last updated Jul 13, 2023

Key facts

NPI
1215616628
Entity type
Organization (NPI type 2)
Primary specialty
Clinic/Center 261Q00000X
Legal business name
GUNDERSEN LUTHERAN MEDICAL CENTER INC
Practice address
3311 Brookview Rd
Rockford, IL 61107-1424
Phone
(608) 782-7300
NPI assigned
Jul 13, 2023
Organization subpart
Yes
Parent organization (as reported)
GUNDERSEN LUTHERAN MEDICAL CENTER INC

Authorized official

Name
Kari B Adank
Title
Cco
Phone
(608) 775-8025

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20221121000252 IL Part B Supplier - Clinic/Group Practice 2163331414 Receives reassigned benefits from 2 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Libertyville, IL; Naperville, IL; Rockford, IL

National Provider Directory

Tax ID family
Lutheran HSP-la Crosse (27 organizations share this tax ID)
Part of
Lutheran HSP-la Crosse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Yes

Addresses

Primary practice location

3311 Brookview Rd
Rockford, IL 61107-1424

Mailing address

1910 South Ave
La Crosse, WI 54601-5467
Phone (608) 782-7300

Other names

  • MILWAUKEE RADIOLOGISTS LTD ROCKFORD SITE Other name

Other providers in Rockford, IL

All providers in Rockford, IL · Clinic/Center in Illinois

Sources for this page

Verify at the official NPI Registry.