Michael Puruckherr, MD
Individual provider Active NPI Pulmonary Disease Physician · Rockford, IL
NPI 1487684353 · NPPES record last updated Mar 4, 2026
Key facts
- NPI
- 1487684353
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pulmonary Disease Physician 207RP1001X
- License
- 036-161516 (IL)
- Practice address
- 1340 Charles St Ste 405
Rockford, IL 61104-2200 - Phone
- (779) 696-6102
- NPI assigned
- Jul 4, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 23
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Swedishamerican Hospital
Morrison Community Hospital District
Practice addresses (Care Compare)
1340 Charles St
Rockford, IL 61104-2200
1401 E State St
Rockford, IL 61104-2315
Phone (815) 489-4400
1625 S State St
Belvidere, IL 61008-5907
2909 N Main St
Rockford, IL 61103-3100
Phone (779) 696-5000
303 N Jackson St
Morrison, IL 61270-3042
Phone (815) 772-4003
5665 N Junction Way
Sa Davis Junction
Davis Junction, IL 61020-9433
Phone (779) 696-9200
6824 Newburg Rd
Sa Valley
Rockford, IL 61108-4330
Phone (779) 696-7610
Hospital & facility affiliations
- Uw Health
- Morrison Community Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in WA, VA, IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041104000272 | WA | Practitioner - Pulmonary Disease |
2466415161 | Reassigns benefits to 1 organization |
| I20190907000264 | VA | Practitioner - Pulmonary Disease |
2466415161 | Reassigns benefits to 1 organization |
| I20230111000218 | IL | Practitioner - Internal Medicine |
2466415161 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-161516 | IL | MD | Pulmonary Disease Physician |
| MD00043378 | WA | MD | Sleep Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Salmon Creek Hospital | Current | Accepting new patients | |
| Swedishamerican Hospital | Current |
Accepting new patients | |
| Swedishamerican Hospital | Pulmonary Disease | Current | Accepting new patients |
| Swedishamerican Hospital | Current |
Accepting new patients | |
| Morrison Community Hospital District | Current |
Accepting new patients | |
| Norton Community Physician Services LLC | Current |
Accepting new patients | |
| Legacy Salmon Creek Hospital | Current |
Accepting new patients | |
| Norton Community Physician Services LLC | Pulmonary Disease | Current |
Accepting new patients |
| Morrison Community Hospital District | Current |
Accepting new patients | |
| Morrison Community Hospital District | Current | Accepting new patients | |
| North Spokane Pulmonary Clinic, P.S. | Pulmonary Disease | Past | Accepting new patients |
| Overlake Internal Medicine Associates Inc PS | Past | Accepting new patients |
Locations
657 W Lincolnway
Morrison, IL 61270
Phone (815) 772-4003
303 N Jackson St
Morrison, IL 61270
Phone (815) 772-4003
6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610
2550 Charles St
Rockford, IL 61108
Phone (779) 696-7285
1340 Charles St
Ste 405
Rockford, IL 61104
Phone (779) 696-5353
98 15th St NW
Ste 208
Norton, VA 24273
Phone (276) 679-7600
100 15th St NW
#307
Norton, VA 24273
Phone (276) 439-1140
98 15th St NW
Ste 207A
Norton, VA 24273
Phone (276) 439-1490
2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 2021046940 | MO | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | MD00043378 | WA | |
| Pulmonary Disease Physician | 207RP1001X | MD00043378 | WA | |
| Sleep Medicine (Internal Medicine) Physician | 207RS0012X | MD00043378 | WA | |
| Pulmonary Disease Physician | 207RP1001X | 0101266905 | VA | |
| Pulmonary Disease Physician | 207RP1001X | 036-161516 | IL | Yes |
Addresses
Primary practice location
1340 Charles St Ste 405
Rockford, IL 61104-2200
Mailing address
700 NE 87TH Ave
Vancouver, WA 98664-1913
Other practice location 1
700 NE 87th Ave
Suite 250
Vancouver, WA 98664-1913
Phone (360) 882-2778
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200104425 | Medicaid | MO | |
| AB32999 | Other | WA | MEDICARE GROUP |
| 1120898 | Medicaid | WA | |
| 7047629 | Medicaid | WA | |
| 036161516 | Medicaid | IL |
Other providers in Rockford, IL
- Nick D Psaltis
- Psychiatric Associates of Rockford SC
- Psychiatric Clinics of Northern Illinois PC
- Pumilia Family Dental LLC
- Pacita Marie Pumilia
- Denise Purvis
- Noel M Pycior
- Patrick J Pyka
- Edward C Pyun Jr.
- Richard J. Pyzynski
All providers in Rockford, IL · Pulmonary Disease Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.