NPIMap

Organization Active NPI

Saint Anthony Medical Center

  • Family Medicine Physician
  • Loves Park, IL
National Provider Identifier
1508567298
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SAINT ANTHONY MEDICAL CENTER
Practice address
9951 Rock Cut Xing
Loves Park, IL 61111-1999
Phone
(815) 639-8500
NPI assigned
Mar 10, 2023
Last updated
Mar 7, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
OSF HEALTHCARE SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Authorized official

Name
Robert C Sehring
Title
Ceo, Osf Healthcare System
Phone
(309) 655-2850

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

9951 Rock Cut Xing
Loves Park, IL 61111-1999

Mailing address

124 SW Adams St
Peoria, IL 61602-1308
Phone (309) 655-2850

Other identifiers 1

IdentifierTypeStateIssuer
999MedicaidIL

Other names 1

  • OSF Healthcare - Medical Group (Non-RHC Billing) Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040102000555 IL Part B Supplier - Clinic/Group Practice 5496654006 Receives reassigned benefits from 73 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Loves Park, IL; Mendota, IL; Rochelle, IL; Rockford, IL

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Part of
Osf Healthcare System

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1678406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1508567298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 SW ADAMS ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021308",
            "telephone_number": "309-655-2850",
            "fax_number": "309-655-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9951 ROCK CUT XING",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611111999",
            "telephone_number": "815-639-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT ANTHONY MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OSF HEALTHCARE SYSTEM",
        "enumeration_date": "2023-03-10",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A",
        "authorized_official_last_name": "SEHRING",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO, OSF HEALTHCARE SYSTEM",
        "authorized_official_telephone_number": "309-655-2850"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "999",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OSF Healthcare - Medical Group (Non-RHC Billing)",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "OSF Healthcare - Medical Group (Non-RHC Billing)",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Loves Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.