Organization Active NPI

OB-Gyne Associates of Libertyville, SC

  • Obstetrics & Gynecology Physician
  • Libertyville, IL
National Provider Identifier
1457563272
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
OB-GYNE ASSOCIATES OF LIBERTYVILLE, SC
Practice address
801 S Milwaukee Avenue, Ste 100
Libertyville, IL 60048
Phone
(847) 680-3400
Fax
(847) 680-3486
NPI assigned
May 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Authorized official

Name
Dr. Rannveig Middleton, MDNPI 1912292822
Title
MD
Phone
(847) 680-3400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

801 S Milwaukee Avenue, Ste 100
Libertyville, IL 60048

Mailing address

801 S Milwaukee Avenue, Ste 100
Libertyville, IL 60048
Phone (847) 680-3400

Other identifiers 1

IdentifierTypeStateIssuer
04900943OtherILBLUE CROSS BLUE SHEILD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080125000652 IL Part B Supplier - Clinic/Group Practice 7618059874 Receives reassigned benefits from 7 practitioners
Practice locations: Libertyville, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0890861OB-Gyne Associates of Libertyville801 S Milwaukee-Suite 100, Libertyville, IL 60048Certificate of waiverAug 25, 2026

National Provider Directory

National Provider Directory

Locations

6440 Grand Ave
#210
Gurnee, IL 60031
Phone (847) 855-8881

6440 Grand Ave
Ste 200
Gurnee, IL 60031

6440 Grand Ave
Ste 210
Gurnee, IL 60031
Phone (847) 855-8881

801 S Milwaukee Ave
Ste 100
Libertyville, IL 60048
Phone (847) 680-3400

801 S Milwaukee Ave
#100
Libertyville, IL 60048
Phone (847) 680-3400

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1147

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1457563272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S MILWAUKEE AVENUE, STE 100",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "60048",
            "telephone_number": "847-680-3400",
            "fax_number": "847-680-3486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 S MILWAUKEE AVENUE, STE 100",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "60048",
            "telephone_number": "847-680-3400",
            "fax_number": "847-680-3486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OB-GYNE ASSOCIATES OF LIBERTYVILLE, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A",
        "authorized_official_last_name": "MIDDLETON",
        "authorized_official_first_name": "RANNVEIG",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "847-680-3400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "04900943",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.