Organization Active NPI

Springfield OB/GYN Group LTD

  • Medical Specialty Clinic/Center
  • Joliet, IL
National Provider Identifier
1639359797
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
SPRINGFIELD OB/GYN GROUP LTD
Practice address
301 Springfield Ave
Joliet, IL 60435-6590
Phone
(815) 729-0330
Fax
(815) 729-0566
NPI assigned
Nov 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Authorized official

Name
Ms. Dianne R Lusinger
Title
Office Manager
Phone
(815) 729-0330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X IL Primary

Addresses

Primary practice location

301 Springfield Ave
Joliet, IL 60435-6590

Mailing address

301 Springfield Ave
Joliet, IL 60435-6590
Phone (815) 729-0330

Other identifiers 2

IdentifierTypeStateIssuer
09908558OtherILBCBS
1922161827OtherILINDIVIDUAL NPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080915000453 IL Part B Supplier - Clinic/Group Practice 5991871089 Receives reassigned benefits from 1 practitioner
Practice locations: Joliet, IL

National Provider Directory

National Provider Directory

Locations

301 Springfield Ave
Joliet, IL 60435
Phone (815) 729-0330

301 Springfield Ave
Ste 1
Joliet, IL 60435
Phone (815) 729-0330

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743033600000",
    "number": "1639359797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SPRINGFIELD AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356590",
            "telephone_number": "815-729-0330",
            "fax_number": "815-729-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SPRINGFIELD AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356590",
            "telephone_number": "815-729-0330",
            "fax_number": "815-729-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGFIELD OB/GYN GROUP LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-06",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A",
        "authorized_official_last_name": "LUSINGER",
        "authorized_official_first_name": "DIANNE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "815-729-0330",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "09908558",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1922161827",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; 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.