Individual provider Active NPI

Artis Christin Kisseih, MD

  • Family Medicine Physician
  • Belvidere, IL
National Provider Identifier
1659908879
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036165290 Issued in IL
Practice address
1700 Henry Luckow LN
Belvidere, IL 61008-1702
Phone
(779) 696-8650
NPI assigned
Mar 26, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036165290 IL Primary

Addresses

Primary practice location

1700 Henry Luckow LN
Belvidere, IL 61008-1702

Mailing address

265 Terrabrook Way
Hampshire, IL 60140-1205
Phone (312) 504-4470

Other practice location 1

3505 N Bell School Rd
Rockford, IL 61114-6624
Phone (312) 504-4470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241010001726 IL Practitioner - Family Practice 0840722294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedishamerican HospitalGroup PAC ID 5799698346, 386 clinicians

Practice addresses (Care Compare)

3505 N Bell School Rd
Rockford, IL 61114-6624
Phone (779) 696-0300

Hospital & facility affiliations

  • American Family Home Health Services LLC Home health agency, Huntley, IL, CCN 148370
  • Uw Health Hospital, Rockford, IL, CCN 140228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036165290ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedishamerican Hospital Family Medicine Current Accepting new patients
Swedishamerican Hospital CurrentSince Sep 30, 2024 Accepting new patients
Swedishamerican Hospital CurrentSince Sep 30, 2024 Accepting new patients

Locations

1700 Henry Luckow Ln
Belvidere, IL 61008
Phone (779) 696-8650

6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610

3505 N Bell School Rd
Rockford, IL 61114
Phone (779) 696-0300

2550 Charles St
Rockford, IL 61108
Phone (779) 696-7285

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1659908879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 TERRABROOK WAY",
            "city": "HAMPSHIRE",
            "state": "IL",
            "postal_code": "601401205",
            "telephone_number": "312-504-4470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 HENRY LUCKOW LN",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610081702",
            "telephone_number": "779-696-8650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3505 N Bell School Rd",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611146624",
            "country_code": "US",
            "telephone_number": "312-504-4470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KISSEIH",
        "first_name": "ARTIS",
        "middle_name": "CHRISTIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-26",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036165290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belvidere, IL

Sources for this page

Verify at the official NPI Registry.