Individual provider Active NPI

Suzana Hamblock, APRN

  • Family Nurse Practitioner
  • Rockford, IL
National Provider Identifier
1740882331
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209-021967 Issued in IL
Practice address
3505 N Bell School Rd
Rockford, IL 61114-6624
Phone
(779) 696-0300
NPI assigned
Nov 10, 2020
Last updated
Feb 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209-021967 IL Primary

Addresses

Primary practice location

3505 N Bell School Rd
Rockford, IL 61114-6624

Mailing address

PO Box 78866
Milwaukee, WI 53278-8866

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address shamblock915155@direct.uwhealth.org

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
I20201210000990 IL Practitioner - Nurse Practitioner 3375955693 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedishamerican HospitalGroup PAC ID 5799698346, 386 clinicians
Cardiorenal Therapeutics of Illinois PLLCGroup PAC ID 5395159677, 32 clinicians

Practice addresses (Care Compare)

1340 Charles St
Rockford, IL 61104-2200

18 W140 Butterfield Rd
Suite 1558
Oakbrook Terrace, IL 60181-4843
Phone (904) 490-0264

6824 Newburg Rd
Sa Valley
Rockford, IL 61108-4330
Phone (779) 696-7610

Hospital & facility affiliations

  • Uw Health Hospital, Rockford, IL, CCN 140228

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209-021967ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiorenal Therapeutics of Illinois PLLC CurrentSince Feb 1, 2022 Accepting new patients
Swedishamerican Hospital CurrentSince Aug 25, 2025 Accepting new patients
Swedishamerican Hospital Current Accepting new patients

Locations

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

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

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

Interoperability endpoints

  • Direct secure messaging: shamblock915155@direct.uwhealth.org

Organizations & group practices 3

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 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": "1604966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1740882331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78866",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532788866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 N BELL SCHOOL RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611146624",
            "telephone_number": "779-696-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMBLOCK",
        "first_name": "SUZANA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-10",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209-021967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shamblock915155@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "3505 N Bell School Rd",
            "city": "Rockford",
            "state": "IL",
            "country_code": "US",
            "postal_code": "611146624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.