Individual provider Active NPI

Laurie Ann Podeszwa, APRN

  • Family Nurse Practitioner
  • Rockford, IL
National Provider Identifier
1407990708
Registry record updated Mar 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209004715 Issued in IL
Practice address
1401 E State St
Rockford, IL 61104-2315
Phone
(815) 489-4891
Fax
(815) 967-5312
NPI assigned
Feb 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209004715 IL Primary

Addresses

Primary practice location

1401 E State St
Rockford, IL 61104-2315

Mailing address

PO Box 1567
Rockford, IL 61110-0067
Phone (815) 489-4891

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
I20101014001391 IL Practitioner - Nurse Practitioner 9436342052 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Insight Physicians Care LLCGroup PAC ID 3870922115, 6 clinicians

Practice addresses (Care Compare)

1 Tiffany PT
Suite 106
Bloomingdale, IL 60108-2915
Phone (224) 653-9507

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Registered Nurse

State licenses

LicenseStateTypeSpecialty
209004715ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Physicians Care LLC CurrentSince Jun 16, 2024 Accepting new patients
Advanced Wound Management Co CurrentSince Jul 15, 2025 Accepting new patients
Illinois Wound Care Centers LLC CurrentSince Jan 1, 2022 Accepting new patients
New Day Wound Care LLC CurrentSince May 1, 2024 Accepting new patients

Locations

3325 N Arlington Heights Rd
Ste 200C
Arlington Heights, IL 60004
Phone (224) 268-7247

1424 N State St
Belvidere, IL 61008
Phone (779) 552-8358

1 Tiffany Pt
Ste 106
Bloomingdale, IL 60108
Phone (224) 653-9507

2021 Midwest Rd
Ste 200
Oak Brook, IL 60523
Phone (312) 599-2555

3470 N Alpine Rd
Rockford, IL 61114
Phone (815) 668-7333

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299456000000",
    "number": "1407990708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1567",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611100067",
            "telephone_number": "815-489-4891",
            "fax_number": "815-967-5312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042315",
            "telephone_number": "815-489-4891",
            "fax_number": "815-967-5312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODESZWA",
        "first_name": "LAURIE",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2011-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209004715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.