NPIMap

Organization Active NPI

Saint Anthony Medical Center

Doing business as OSF Healthcare - Medical Group - Rock Cut

  • Rural Health Clinic/Center
  • Loves Park, IL
National Provider Identifier
1558067975
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SAINT ANTHONY MEDICAL CENTER
Doing business as
OSF Healthcare - Medical Group - Rock Cut
Practice address
9951 Rock Cut Xing
Loves Park, IL 61111-1999
Phone
(815) 639-8500
NPI assigned
Feb 7, 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
Phone
(309) 655-2850

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 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 names 1

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

Medicare participation

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

Enrollment records 1

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1558067975. Details of each certification follow.

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
CorporationNon-profit
Enrollment address
9951 Rock Cut Xing
Ste 102, 200, 300
Loves Park, IL 61111-1999
Related CCNs
140233

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

Other NPIs with the same Medicare PAC ID 3

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

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
14D2107481Osf Healthcare - Medical Group - Rock Cut9951 Rock Cut Crossing, Loves Park, IL 61111Certificate of waiverJan 13, 2028

National Provider Directory

National Provider Directory
Tax ID family
St Anthony Medical Cent8 organizations share this tax ID, including this one
Part of
Osf Healthcare System

Other organizations with this tax ID 7

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

Locations

1954 Gateway Center Dr
Belvidere, IL 61008
Phone (815) 544-7400

109 N Franklin St
Byron, IL 61010
Phone (815) 234-3900

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

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

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

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

698 Featherstone Rd
Ste 250
Rockford, IL 61107
Phone (815) 399-4404

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

Ownership & related parties

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 EmployeeClinic Manager Feb 1, 2023
Operational/Managerial ControlClinic 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 EmployeeChief Financial Officer Nov 8, 2024
Operational/Managerial ControlChief 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 EmployeeChief Executive Officer Oct 20, 2017
Operational/Managerial ControlChief 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 EmployeePhysician Director Feb 1, 2023
Operational/Managerial ControlPhysician 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

Owners & managing parties with NPI records 2

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

Facilities with the same owner 76

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

View all 76

Practitioners & affiliated clinicians

Practitioners 63

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 63

NPI Registry JSON

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

{
    "created_epoch": "1675728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1558067975",
    "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": "2023-02-07",
        "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",
        "authorized_official_telephone_number": "309-655-2850"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OSF Healthcare - Medical Group - Rock Cut",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Loves Park, IL

Sources for this page

Verify at the official NPI Registry.