NPIMap

Organization Active NPI

Northern Illinois Medical Center

  • Rehabilitation Hospital Unit
  • Woodstock, IL
National Provider Identifier
1497764526
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
0003889 Issued in IL
Legal business name
NORTHERN ILLINOIS MEDICAL CENTER
Practice address
3701 Doty Rd FL 2
Woodstock, IL 60098-7509
Phone
(153) 382-5008
Fax
(815) 334-3948
NPI assigned
Aug 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Authorized official

Name
Catie L Schmidt
Title
President
Phone
(815) 338-2500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 0003889 IL Primary

Addresses

Primary practice location

3701 Doty Rd FL 2
Woodstock, IL 60098-7509

Mailing address

4201 W Medical Center Dr
McHenry, IL 60050-8409
Phone (815) 344-5000

Other identifiers 1

IdentifierTypeStateIssuer
319OtherILBLUE CROSS

Other names 1

  • NORTHWESTERN MEDICINE MCHENRY HOSPITAL Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071106000126 IL Part A Provider - Hospital 4183617822 Practice locations: Woodstock, IL

Hospital certification: CCN 14T116

Legal name
NORTHERN ILLINOIS MEDICAL CENTER
Doing business as
NORTHWESTERN MEDICINE MCHENRY HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Jun 1, 1982 in IL
Enrollment address
3701 Doty Rd
FL 2
Woodstock, IL 60098-7509
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Centegra Hospital - McHenryCCN 14T116
Ownership
Non-profit
Certified
Jul 1, 2004

National Provider Directory

National Provider Directory
Tax ID family
Centergra Northern Ill4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

3701 Doty Rd
Fl 2
Woodstock, IL 60098
Phone (815) 338-2500

Ownership & related parties

All disclosed owners & managing parties 28

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Anthony K Kesman Individual Corporate DirectorBoard Member Sep 1, 2018
Jose Carlos Gonzalez-Mendez Individual Corporate DirectorBoard Member Sep 1, 2022
Sharmi Jayachandran Individual Corporate Director Sep 1, 2023
Catie Schmit Individual Corporate Director Jan 1, 2024
W-2 Managing Employee Jan 1, 2024
James Zallie Individual Corporate DirectorBoard Member Sep 1, 2018
Michael J Leonard Individual Corporate DirectorBoard Member Sep 1, 2022
Carol L Bernick Individual Corporate DirectorBoard Member Sep 1, 2022
Michael J Mullen Individual Corporate OfficerDirector Rev Cycle Sep 1, 2021
Aaron S Epstein Individual Corporate DirectorBoard Member Sep 1, 2024
John J Guido Individual Corporate Director Jan 1, 2024
Dean M Harrison Individual Corporate DirectorBoard Member Sep 1, 2018
Kermit R Crawford Individual Corporate DirectorBoard Member Sep 1, 2018
Howard B Chrisman Individual Corporate DirectorBoard Member Jan 1, 2023
Thomas a Carey Individual Corporate DirectorBoard Member Oct 1, 2007
William P Flesch Individual Corporate DirectorBoard Member Sep 1, 2022
Michele C Montpetit Individual Corporate DirectorBoard Member Sep 1, 2024
William a Earman Individual Corporate DirectorBoard Member Sep 1, 2024
Charles Ruth Individual Corporate DirectorBoard Member Oct 1, 2007
Ankur R Behl Individual Corporate Director Sep 1, 2023
Joseph R Crane Individual Corporate DirectorBoard Member Sep 1, 2022
Scott P Serota Individual Corporate DirectorBoard Member Sep 1, 2022
Forrest R Whittaker Individual Corporate DirectorBoard Member Sep 1, 2018
James Thorpe Individual Corporate DirectorBoard Member Jan 1, 2018
Northwestern Memorial Healthcare Organization, Chicago, IL Corporation, Non-profit 5% Or Greater Direct Ownership Interest Oct 5, 2020 100%
Kevin Poorten Individual Corporate DirectorBoard Member Sep 1, 2022
Scott L Gwilliam Individual Corporate DirectorBoard Member Sep 1, 2022
Stephen L Davis Individual Corporate DirectorBoard Member Sep 1, 2022
Deborah S Saran Individual Corporate DirectorBoard Member Sep 1, 2018

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 13

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 13

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1497764526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 W MEDICAL CENTER DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508409",
            "telephone_number": "815-344-5000",
            "fax_number": "815-344-9848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 DOTY RD FL 2",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600987509",
            "telephone_number": "153-382-5008",
            "fax_number": "815-334-3948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN ILLINOIS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "SCHMIDT",
        "authorized_official_first_name": "CATIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-338-2500"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "IL",
            "license": "0003889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "319",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTHWESTERN MEDICINE MCHENRY HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodstock, IL

Sources for this page

Verify at the official NPI Registry.