Individual provider Active NPI

Jenny Catherine Hennegar, APRN

  • Pediatric Nurse Practitioner
  • Roscoe, IL
National Provider Identifier
1760101562
Registry record updated Sep 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
209025577 Issued in IL
Practice address
4282 E Rockton Rd
Roscoe, IL 61073-7420
Phone
(779) 696-9000
NPI assigned
Aug 24, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 209025577 IL Primary

Addresses

Primary practice location

4282 E Rockton Rd
Roscoe, IL 61073-7420

Mailing address

4282 E Rockton Rd
Roscoe, IL 61073-7420
Phone (779) 696-9000

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
I20250813001784 IL Practitioner - Nurse Practitioner 9436657996 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

7974 Uw Health CT
Middleton, WI 53562-5531

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Swedishamerican Hospital Current Accepting new patients
Swedishamerican Hospital CurrentSince Jul 1, 2025 Accepting new patients
Swedishamerican Hospital CurrentSince Jul 1, 2025 Accepting new patients

Locations

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

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

4282 E Rockton Rd
Roscoe, IL 61073
Phone (779) 676-8160

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1661299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1760101562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4282 E ROCKTON RD",
            "city": "ROSCOE",
            "state": "IL",
            "postal_code": "610737420",
            "telephone_number": "779-696-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4282 E ROCKTON RD",
            "city": "ROSCOE",
            "state": "IL",
            "postal_code": "610737420",
            "telephone_number": "779-696-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNEGAR",
        "first_name": "JENNY",
        "middle_name": "CATHERINE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-24",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209025577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roscoe, IL

Sources for this page

Verify at the official NPI Registry.