NPIMap

Organization Active NPI

Mercy Health System Corporation

Doing business as Mercy Woodstock Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Woodstock, IL
National Provider Identifier
1720123425
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
310800 Issued in WI
Legal business name
MERCY HEALTH SYSTEM CORPORATION
Doing business as
Mercy Woodstock Medical Center
Practice address
2000 Lake Ave
Room 1423, 1210, 1083, 1047, 1291
Woodstock, IL 60098-6009
Phone
(815) 337-1560
NPI assigned
Feb 20, 2007
Last updated
Jun 16, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
MERCY HEALTH CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Authorized official

Name
Joseph D Malas
Title
Cfo
Phone
(815) 971-6738

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 310800 WI Primary
Customized Equipment (DME) 332BC3200X NU

Addresses

Primary practice location

2000 Lake Ave
Room 1423, 1210, 1083, 1047, 1291
Woodstock, IL 60098-6009

Mailing address

1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6000

Other practice location 1

2000 Lake Ave
Room 1208
Woodstock, IL 60098-7401
Phone (815) 337-7100

Other identifiers 2

IdentifierTypeStateIssuer
5632221OtherILBCBSIL ORTHOTIC
14D0962058OtherCLIA #

Other names 1

  • MERCY WOODSTOCK MEDICAL CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930065590 IL DME Supplier - Pharmacy 7416860440 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Woodstock, IL
O20110601000268 IL DME Supplier - Physician - General PracticeDME Supplier - Independently-Practicing Physical TherapistDME Supplier - Independently-Practicing Occupational TherapistDME Supplier - Medical Supply Company With Orthotic-Prosthetic 7416860440 Practice locations: Woodstock, IL

Other NPIs with the same Medicare PAC ID 13

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

View all 13

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

2000 Lake Ave
Rm 1208
Woodstock, IL 60098
Phone (815) 337-7100

2000 Lake Ave
Rm 1423
Woodstock, IL 60098
Phone (815) 337-1560

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750032000000",
    "number": "1720123425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MINERAL POINT AVE",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535482940",
            "telephone_number": "608-756-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 LAKE AVE",
            "address_2": "ROOM 1423, 1210, 1083, 1047, 1291",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600986009",
            "telephone_number": "815-337-1560"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Lake Ave",
            "address_2": "ROOM 1208",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "IL",
            "postal_code": "600987401",
            "country_code": "US",
            "telephone_number": "815-337-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MERCY HEALTH SYSTEM CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY HEALTH CORPORATION",
        "enumeration_date": "2007-02-20",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A",
        "authorized_official_last_name": "MALAS",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "815-971-6738"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WI",
            "license": "310800",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIL ORTHOTIC",
            "identifier": "5632221",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA #",
            "identifier": "14D0962058",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MERCY WOODSTOCK MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MERCY WOODSTOCK MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodstock, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.