Saint Anthony Medical Center
Organization Active NPI Hematology & Oncology Physician · Rockford, IL
NPI 1942248802 · NPPES record last updated Mar 7, 2024
Key facts
- NPI
- 1942248802
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Hematology & Oncology Physician 207RH0003X
- License
- 0002253 (IL)
- Legal business name
- SAINT ANTHONY MEDICAL CENTER
- Practice address
- 5666 E State St
Rockford, IL 61108-2425 - Phone
- (815) 226-2000
- Fax
- (815) 395-5449
- NPI assigned
- Jun 3, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- OSF HEALTHCARE SYSTEM
Authorized official
- Name
- Robert C Sehring
- Title
- Ceo
- Phone
- (309) 655-2850
Other NPIs on the same Medicare enrollment 16
Other NPIs with the same Medicare PAC ID 3
Practitioners 76
-
Faheem Ahmad, MD
-
Alissa M Bartel, APN FNP-BC
-
Alexia L Ceniseros, APRN, CNP
-
Lydia Jane Combs, NP
-
Kelechi Emuchay, MD
-
Megan Paige Griesman, APRN
-
Benjamin Guth, DNP
-
Muhammad A Habib, MD
-
Alexandra Incandela, DPM
-
Michele Dawn Johnson, APN
-
Jack W Lenox, M.D.
-
Thomas Magerl, APN
-
Nicole M Moore, APN
-
Kinda Muslemani, M.D.
-
Mary B O'Meara, FNP
-
Andrea P Rossow, APN
-
Noah James Simon, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040102000555 | IL | Part B Supplier - Clinic/Group Practice | 5496654006 |
Receives reassigned benefits from 73 practitioners 16 other NPIs on this enrollment Practice locations: Loves Park, IL; Mendota, IL; Rochelle, IL; Rockford, IL |
National Provider Directory
- Part of
- Eastland Med Plaza Surg
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician |
207RH0003X | 0002253 | IL | Yes |
| Neurological Surgery Physician |
207T00000X | |||
| Neurology Physician |
2084N0400X | |||
| Hospitalist Physician |
208M00000X |
Addresses
Primary practice location
5666 E State St
Rockford, IL 61108-2425
Mailing address
124 SW Adams St
Peoria, IL 61602-1308
Phone (309) 655-2850
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CC8684 | Other | IL | MEDICARE RAILROAD |
| 0010115223 | Other | IL | BLUE CROSS BLUE SHIELD |
| DE3455 | Other | IL | MAEDICARE RAILROAD |
| DE5346 | Other | IL | MEDICARE RAILROAD |
Other names
- OSF Saint Anthony Medical Center
- Saint Anthony Medical Center Hospital Based Physicians
Other providers in Rockford, IL
- Saint Anthony Medical Center
- Saint Anthony Medical Center
- Saint Anthony Medical Center
- Saint Anthony Medical Center
- Saint Anthony Medical Center
- Saint Anthony Medical Center
- Saint Anthony Medical Center
- Naoshiba Aziz Sajid
- Emen Salam
- Ribhi Salamah
All providers in Rockford, IL · Hematology & Oncology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.