Individual provider Active NPI

Sandra L Lee, APRN, CNP

  • Primary Care Nurse Practitioner
  • Rockford, IL
National Provider Identifier
1710365176
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
209012818 Issued in IL
Practice address
444 Roxbury Rd
Rockford, IL 61107-5059
Phone
(815) 398-3000
Fax
(815) 391-5076
NPI assigned
May 18, 2015
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209012818 IL
Primary Care Nurse Practitioner 363LP2300X 209012818 IL Primary

Addresses

Primary practice location

444 Roxbury Rd
Rockford, IL 61107-5059

Mailing address

444 Roxbury Rd
Rockford, IL 61107-5059
Phone (815) 398-3000

Other practice location 1

5000 Prairie Rose Dr
Roscoe, IL 61073-7792
Phone (815) 971-2000

Other identifiers 1

IdentifierTypeStateIssuer
1710365176MedicaidWI

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150720000066 IL Practitioner - Nurse Practitioner 7315250412 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

444 Roxbury Rd
Rockford, IL 61107-5059
Phone (815) 398-3000

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Health Physicians CurrentSince Jun 18, 2015 Accepting new patients
RMH Pathologists, LTD Current Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 22, 2025 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

444 Roxbury Rd
Rockford, IL 61107
Phone (815) 395-9196

Organizations & group practices 4

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

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": "1431907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1710365176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075059",
            "telephone_number": "815-398-3000",
            "fax_number": "815-391-5076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075059",
            "telephone_number": "815-398-3000",
            "fax_number": "815-391-5076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5000 Prairie Rose Dr",
            "address_purpose": "LOCATION",
            "city": "Roscoe",
            "state": "IL",
            "postal_code": "610737792",
            "country_code": "US",
            "telephone_number": "815-971-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "SANDRA",
        "middle_name": "L",
        "credential": "APRN, CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-18",
        "last_updated": "2026-09-29",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209012818",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IL",
            "license": "209012818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710365176",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.