Individual provider Active NPI

Olis Denise Runestad, APRN, CNP

  • Nurse Practitioner
  • Dekalb, IL
National Provider Identifier
1710689872
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209026915 Issued in IL
Practice address
1 Kish Hospital Dr
Dekalb, IL 60115-9602
Phone
(815) 766-7334
Fax
(815) 766-9768
NPI assigned
Mar 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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 041370130 IL
Nurse Practitioner 363L00000X 209026915 IL Primary

Addresses

Primary practice location

1 Kish Hospital Dr
Dekalb, IL 60115-9602

Mailing address

1 Kish Hospital Dr
Dekalb, IL 60115-9602
Phone (815) 766-7334

Other names 1

  • Olis Denise Freeman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230801002872 IL Practitioner - Nurse Practitioner 4284095647 Reassigns benefits to 2 organizations
I20240216003773 WI Practitioner - Nurse Practitioner 4284095647 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Wisconsin Emergency Associates SCGroup PAC ID 3274561055, 47 clinicians

Practice addresses (Care Compare)

1969 W Hart Rd
Beloit, WI 53511-2230
Phone (608) 364-5566

5605 E Rockton Rd
Roscoe, IL 61073-7601
Phone (815) 525-4100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
85.73 of 100Reported as group
Quality
87.42
Promoting interoperability
100
Improvement activities
40
Cost
65.02

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041370130ILMDNurse Practitioner
209026915ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stoughton Hospital Association CurrentSince Jun 1, 2024 Accepting new patients
Stoughton Hospital Association CurrentSince Jun 1, 2024 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Oct 23, 2023 Accepting new patients
Southern Wisconsin Emergency Associates SC CurrentSince Dec 1, 2023 Accepting new patients
Edgerton Hospital and Health Services CurrentSince Mar 20, 2024 Accepting new patients
Edgerton Hospital and Health Services Inc. Current Accepting new patients
Edgerton Hospital and Health Services, Inc CurrentSince Mar 20, 2024 Accepting new patients
Swea Fort SC CurrentSince Oct 1, 2024 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Oct 23, 2023 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations (25 of 33)

2635 Church Rd
Ste 101
Aurora, IL 60502
Phone (630) 315-6900

820 S State Route 59
Bartlett, IL 60103
Phone (630) 213-9600

820 S State Route 59
Ste A
Bartlett, IL 60103
Phone (630) 483-5930

Dept 5777
Carol Stream, IL 60122

171 N Aberdeen St
Ste 100
Chicago, IL 60607
Phone (312) 694-2273

1333 W Belmont Ave
Ste 100
Chicago, IL 60657
Phone (312) 693-2273

1135 S Delano Ct E
Ste B201
Chicago, IL 60605
Phone (312) 694-2500

360 Station Dr
Ste 300A
Crystal Lake, IL 60014
Phone (815) 788-7500

350 S Waukegan Rd
Ste 150
Deerfield, IL 60015
Phone (312) 926-3107

1 Kish Hospital Dr
DeKalb, IL 60115
Phone (815) 754-1521

1630 Sherman Ave
Ste 130
Evanston, IL 60201
Phone (224) 271-4400

885 Roosevelt Rd
Ste 100
Glen Ellyn, IL 60137
Phone (630) 384-6200

2701 Patriot Blvd
Ste 110
Glenview, IL 60026
Phone (312) 694-2273

10350 Haligus Rd
Ste A
Huntley, IL 60142
Phone (815) 455-6100

525 Rockland Rd
Ste 100
Lake Bluff, IL 60044
Phone (847) 475-2273

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

2507 N Richmond Rd
Ste B
McHenry, IL 60051
Phone (815) 206-7500

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

636 Raymond Dr
Ste 107
Naperville, IL 60563
Phone (630) 359-8396

15300 West Ave
Ste 20LL
Orland Park, IL 60462

15300 West Ave
Ste 20
Orland Park, IL 60462
Phone (708) 460-5550

5605 E Rockton Rd
Roscoe, IL 61073
Phone (815) 525-4000

1302 N Main St
Sandwich, IL 60548
Phone (815) 486-8484

2900 Foxfield Rd
Ste 100
St Charles, IL 60174
Phone (630) 377-6500

1850 Gateway Dr
Ste 100
Sycamore, IL 60178
Phone (815) 217-3252

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 1

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": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1710689872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KISH HOSPITAL DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159602",
            "telephone_number": "815-766-7334",
            "fax_number": "815-766-9768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KISH HOSPITAL DR",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601159602",
            "telephone_number": "815-766-7334",
            "fax_number": "815-766-9768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNESTAD",
        "first_name": "OLIS",
        "middle_name": "DENISE",
        "name_prefix": "Ms.",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-21",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "041370130",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209026915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLIS",
            "last_name": "FREEMAN",
            "middle_name": "DENISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dekalb, IL

Sources for this page

Verify at the official NPI Registry.