NPIMap

Saint Anthony Medical Center

Organization Active NPI Rural Health Clinic/Center · Loves Park, IL

NPI 1558067975 · NPPES record last updated Mar 7, 2024

Key facts

NPI
1558067975
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
SAINT ANTHONY MEDICAL CENTER
Practice address
9951 Rock Cut Xing
Loves Park, IL 61111-1999
Phone
(815) 639-8500
NPI assigned
Feb 7, 2023
Organization subpart
Yes
Parent organization (as reported)
OSF HEALTHCARE SYSTEM

Authorized official

Name
Robert C Sehring
Title
Ceo
Phone
(309) 655-2850

Owners & managing parties with NPI records 2

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

Other NPIs with the same Medicare PAC ID 3

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

Corporate family (same tax ID) 7

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

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

Facilities with the same owner 76

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

View all 76

Practitioners 74

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

View all 74

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2107481Osf Healthcare - Medical Group - Rock Cut
9951 Rock Cut Crossing, Loves Park, IL 61111		Certificate of waiverJan 13, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Rural health clinic certification: CCN 148663

Legal name
SAINT ANTHONY MEDICAL CENTER
Doing business as
OSF HEALTHCARE - MEDICAL GROUP - ROCK CUT
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 6, 2024
Last certification
Feb 6, 2024
Ownership / control type
2B
Organization structure
Corporation · Non-profit
Enrollment address
9951 Rock Cut Xing
Ste 102, 200, 300
Loves Park, IL 61111-1999
Related CCNs
140233

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Patricia a Brazeau
Individual 		Corporate Officer Oct 1, 2006
Corporate Director Oct 1, 2006
Brooke MC-Gee Grundstrom
Individual 		Contracted Managing Employee
Clinic Manager		 Feb 1, 2023
Operational/Managerial Control
Clinic Manager		 Feb 1, 2023
Anne M Ziegler
Individual 		Corporate Director Jan 1, 2021
Melanie R Mann
Individual 		Corporate Officer Oct 6, 2024
Corporate Director Oct 1, 2006
August Querciagrossa
Individual 		W-2 Managing Employee Aug 17, 2022
Operational/Managerial Control Aug 17, 2022
Gerald J McShane
Individual 		Corporate Director Sep 1, 1996
Osf Healthcare Ministries
Organization · Peoria, IL
Corporation, Non-profit 		Operational/Managerial Control Nov 1, 2024
Kathleen F Williams
Individual 		Corporate Officer Nov 1, 2014
Corporate Director Jan 1, 2003
Kirsten M Largent
Individual 		Corporate Officer Nov 8, 2024
W-2 Managing Employee
Chief Financial Officer		 Nov 8, 2024
Operational/Managerial Control
Chief Financial Officer		 Nov 8, 2024
Osf Healthcare System
Organization · Peoria, IL
Corporation, Non-profit, Chain home office 		Operational/Managerial Control Sep 1, 2007
Robert C Sehring
Individual 		Corporate Officer Oct 20, 2017
Corporate Director Oct 20, 2017
W-2 Managing Employee
Chief Executive Officer		 Oct 20, 2017
Operational/Managerial Control
Chief Executive Officer		 Oct 20, 2017
Judith a Duvall
Individual 		Corporate Officer Oct 1, 2006
Corporate Director Oct 1, 1989
Carisa a Neumann
Individual 		Corporate Director Jan 1, 2021
Amy Rose Henderson
Individual 		Contracted Managing Employee
Physician Director		 Feb 1, 2023
Operational/Managerial Control
Physician Director		 Feb 1, 2023
Paula Carynski
Individual 		W-2 Managing Employee Jul 20, 2013
Operational/Managerial Control Jul 20, 2013
Brian J Silverstein
Individual 		Corporate Director Oct 1, 2015
Paula K Selamat
Individual 		Corporate Director Oct 6, 2024
Bridget J Meidl
Individual 		Corporate Director Nov 1, 2014

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20230613002434 IL Part a Provider - Rural Health Clinic 5496654006 Practice locations: Loves Park, IL

National Provider Directory

Tax ID family
Saint Anthony Medical C (8 organizations share this tax ID)
Part of
Eastland Med Plaza Surg

Locations

109 N Franklin St
Ste 151
Byron, IL 61010
Phone (815) 226-2000

403 E 1st St
Ste 353
Dixon, IL 61021
Phone (815) 284-5710

9951 Rock Cut Xing
Ste 300
Loves Park, IL 61111

1601 Mercury Ct
Ottawa, IL 61350
Phone (815) 433-6090

444 Roxbury Rd
Ste 200
Rockford, IL 61107
Phone (815) 484-7470

444 Roxbury Rd
Ste 300
Rockford, IL 61107
Phone (815) 484-7490

6067 Strathmoor Dr
#J
Rockford, IL 61107
Phone (815) 226-8035

5510 E State St
Ste 161
Rockford, IL 61108
Phone (815) 395-4505

5668 E State St
Ste 1500
Rockford, IL 61108
Phone (815) 484-7330

5713 Strathmoor Dr
Rockford, IL 61107
Phone (815) 399-3968

810 N Alpine Rd
Rockford, IL 61107
Phone (815) 395-9567

5668 E State St
#400
Rockford, IL 61108
Phone (815) 398-7755

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Yes

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 names

  • OSF Healthcare - Medical Group - Rock Cut Doing business as

Other providers in Loves Park, IL

All providers in Loves Park, IL · Rural Health Clinic/Center in Illinois

Sources for this page

Verify at the official NPI Registry.