Individual provider Active NPI

Tracy L. Cole, MD

  • Internal Medicine Physician
  • Loves Park, IL
National Provider Identifier
1780794966
Registry record updated Jan 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036095450 Issued in IL
Practice address
7702 N Alpine Rd
Loves Park, IL 61111-3107
Phone
(815) 971-2000
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036095450 IL Primary

Addresses

Primary practice location

7702 N Alpine Rd
Loves Park, IL 61111-3107

Mailing address

7702 N Alpine Rd
Loves Park, IL 61111-3107
Phone (815) 971-2000

Other identifiers 1

IdentifierTypeStateIssuer
036095450MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036095450ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Health Physicians Current Accepting new patients

Locations

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

7702 N Alpine Rd
Loves Park, IL 61111
Phone (815) 971-3397

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

5970 Churchview Dr
Rockford, IL 61107
Phone (815) 971-8990

Organizations & group practices 1

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263945600000",
    "number": "1780794966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7702 N ALPINE RD",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611113107",
            "telephone_number": "815-971-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7702 N ALPINE RD",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611113107",
            "telephone_number": "815-971-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "TRACY",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2010-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036095450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036095450",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loves Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.