Individual provider Active NPI

Rebecca Sedlock, APRN

  • Family Nurse Practitioner
  • Streator, IL
National Provider Identifier
1437913555
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.029293 Issued in IL
Practice address
111 Spring St
Streator, IL 61364-3332
Phone
(815) 672-4587
NPI assigned
Feb 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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 209.029293 IL Primary

Addresses

Primary practice location

111 Spring St
Streator, IL 61364-3332

Mailing address

111 Spring St
Streator, IL 61364-3332
Phone (815) 672-4587

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
I20240307001325 IL Practitioner - Nurse Practitioner 6204272776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint James HospitalGroup PAC ID 0648187252, 74 clinicians

Practice addresses (Care Compare)

111 Spring St
FL 4
Streator, IL 61364-3332
Phone (815) 672-4587

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.029293ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint James Hospital CurrentSince Feb 23, 2024 Accepting new patients
Saint James Hospital CurrentSince Feb 23, 2024 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Saint James Hospital Past Accepting new patients

Locations

111 Spring St
Streator, IL 61364
Phone (815) 672-4587

111 Spring St
Fl 4
Streator, IL 61364
Phone (815) 672-4587

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 3

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": "1707350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1437913555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 SPRING ST",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613643332",
            "telephone_number": "815-672-4587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SPRING ST",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613643332",
            "telephone_number": "815-672-4587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDLOCK",
        "first_name": "REBECCA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-08",
        "last_updated": "2024-06-26",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.029293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Streator, IL

Sources for this page

Verify at the official NPI Registry.