Individual provider Active NPI

Madeline Rose Wetterhahn, MD MPH

  • Obstetrics & Gynecology Physician
  • Rockford, IL
National Provider Identifier
1982166195
Registry record updated Jan 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
68678 Issued in AZ
Practice address
1200 W State St
Rockford, IL 61102-2112
Phone
(815) 490-1600
Fax
(815) 490-1881
NPI assigned
Apr 5, 2019
Last updated
Jan 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036177708 IL
Obstetrics & Gynecology Physician 207V00000X 68678 AZ Primary

Addresses

Primary practice location

1200 W State St
Rockford, IL 61102-2112

Mailing address

1200 W State St
Rockford, IL 61102-2112
Phone (815) 490-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20230626002277 AZ Practitioner - Obstetrics/Gynecology 2062741804

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Tufts University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Crusaders Central Clinic AssociationGroup PAC ID 5799682993, shared by 7 NPIs, 31 clinicians
North Country Healthcare IncGroup PAC ID 8820981053, shared by 3 NPIs, 20 clinicians

Practice addresses (Care Compare)

1100 Broadway
Rockford, IL 61104-1429
Phone (815) 490-1600

2920 N 4TH St
Flagstaff, AZ 86004-1816

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036177708ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Country Healthcare, Inc. Current Accepting new patients
North Country Healthcare, Inc. CurrentSince Jun 6, 2023 Accepting new patients
North Country Healthcare, Inc. Family Medicine Current Accepting new patients
North Country Healthcare, Inc. CurrentSince Jun 6, 2023 Accepting new patients
North Country Healthcare Inc Past Accepting new patients

Locations

2920 N 4th St
Flagstaff, AZ 86004
Phone (928) 213-6100

620 Lee St
Winslow, AZ 86047
Phone (928) 288-8700

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768003200000",
    "number": "1982166195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611022112",
            "telephone_number": "815-490-1600",
            "fax_number": "815-490-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611022112",
            "telephone_number": "815-490-1600",
            "fax_number": "815-490-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WETTERHAHN",
        "first_name": "MADELINE",
        "middle_name": "ROSE",
        "credential": "MD MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-05",
        "last_updated": "2026-01-10",
        "certification_date": "2026-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036177708",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "68678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.