Individual provider Active NPI

William Staehle, M.D.

  • Internal Medicine Physician
  • Long Grove, IL
National Provider Identifier
1811287105
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
125059701 Issued in IL
Practice address
3880 Salem Lake Dr
Ste F
Long Grove, IL 60047-5292
Phone
(847) 719-2220
Fax
(847) 719-2265
NPI assigned
Apr 8, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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 125059701 IL Primary

Addresses

Primary practice location

3880 Salem Lake Dr
Ste F
Long Grove, IL 60047-5292

Mailing address

3880 Salem Lake Dr
Ste F
Long Grove, IL 60047-5292
Phone (847) 719-2220

Other practice location 1

5970 Churchview Dr
Rockford, IL 61107-2574
Phone (815) 971-2000

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150319001005 IL Practitioner - Internal Medicine 9436476041 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rockford Health PhysiciansGroup PAC ID 2567374036, 520 clinicians

Practice addresses (Care Compare)

5970 Churchview Dr
Rockford, IL 61107-2574
Phone (815) 971-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125059701ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
RMH Pathologists, LTD Current Accepting new patients
Best Practices Inpatient Care,LTD Internal Medicine CurrentSince Feb 21, 2015 Accepting new patients
Rockford Health Physicians CurrentSince May 19, 2020 Accepting new patients
Best Practices Inpatient Care, LTD. Internal Medicine CurrentSince Feb 21, 2015 Accepting new patients
Best Practices Inpatient Care, LTD. Internal Medicine Current Accepting new patients

Locations

800 W Central Rd
Arlington Hts, IL 60005
Phone (847) 618-6150

106 Barrington Commons Ct
Unit 1790
Barrington, IL 60011
Phone (847) 719-2220

Carol Stream, IL 60122

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

3880 Salem Lake Dr
Ste F
Long Grove, IL 60047
Phone (847) 719-2220

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

2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310

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

450 W State Route 22
South Barrington, IL 60010
Phone (847) 381-0123

Organizations & group practices 5

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": "1302220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1811287105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3880 SALEM LAKE DR",
            "address_2": "STE F",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "600475292",
            "telephone_number": "847-719-2220",
            "fax_number": "847-719-2265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 SALEM LAKE DR",
            "address_2": "STE F",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "600475292",
            "telephone_number": "847-719-2220",
            "fax_number": "847-719-2265"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5970 Churchview Dr",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611072574",
            "country_code": "US",
            "telephone_number": "815-971-2000",
            "fax_number": "815-971-9267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAEHLE",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-08",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125059701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Grove, IL

Sources for this page

Verify at the official NPI Registry.