Heather Vittetow

Individual provider Active NPI Acute Care Nurse Practitioner · Rockford, IL

NPI 1861235285 · NPPES record last updated Dec 11, 2024

Key facts

NPI
1861235285
Entity type
Individual (NPI type 1)
Primary specialty
Acute Care Nurse Practitioner 363LA2100X
License
209.029877 (IL)
Practice address
209 9TH St Ste 200
Rockford, IL 61104-2235
Phone
(779) 696-8700
NPI assigned
Jun 13, 2024
Sex
Female
Sole proprietor
No

Organizations & group practices 10

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.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedishamerican Hospital (386 clinicians)

Practice addresses (Care Compare)

209 9TH St
Suite 200
Rockford, IL 61104-2235
Phone (779) 696-2750

Hospital & facility affiliations

  • Uw Health Hospital · Rockford, IL · CCN 140228

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240731001638 IL Practitioner - Nurse Practitioner 3870030539 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Swedishamerican Hospital Current
since Jul 16, 2024
Accepting new patients
Swedishamerican Hospital Current Accepting new patients
Swedishamerican Hospital Current
since Jul 16, 2024
Accepting new patients

Locations

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

209 9th St
Ste 200
Rockford, IL 61104
Phone (779) 696-2750

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

1401 E State St
Rockford, IL 61104
Phone (815) 489-4267

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 209.029877 IL Yes

Addresses

Primary practice location

209 9TH St Ste 200
Rockford, IL 61104-2235

Mailing address

6875 N Friday Rd
Byron, IL 61010-8821

Other practice location 1

1401 E State St
Rockford, IL 61104-2315
Phone (779) 696-4400

Other providers in Rockford, IL

All providers in Rockford, IL · Acute Care Nurse Practitioner in Illinois

Sources for this page

Verify at the official NPI Registry.