Madeline Rose Wetterhahn, MD MPH
Individual provider Active NPI Obstetrics & Gynecology Physician · Rockford, IL
NPI 1982166195 · NPPES record last updated Jan 10, 2026
Key facts
- NPI
- 1982166195
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 68678 (AZ)
- Practice address
- 1200 W State St
Rockford, IL 61102-2112 - Phone
- (815) 490-1600
- Fax
- (815) 490-1881
- NPI assigned
- Apr 5, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Medicare Care Compare profile
- 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 Association
North Country Healthcare Inc
Practice addresses (Care Compare)
1100 Broadway
Rockford, IL 61104-1429
Phone (815) 490-1600
2920 N 4TH St
Flagstaff, AZ 86004-1816
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230626002277 | AZ | Practitioner - Obstetrics/Gynecology | 2062741804 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036177708 | IL | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Country Healthcare, Inc. | Current |
Accepting new patients | |
| North Country Healthcare, Inc. | Family Medicine | Current | Accepting new patients |
| North Country Healthcare, Inc. | Current |
Accepting new patients | |
| North Country Healthcare, Inc. | Current | 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 036177708 | IL | |
| Obstetrics & Gynecology Physician | 207V00000X | 68678 | AZ | Yes |
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
NPI Registry JSON
{
"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
- Sean Michael West
- Sheri West
- David Eugene Wester
- Ryan R Westerberg
- Rachel M Wetter
- Pamela J Wetzel
- Siera M Wetzel
- Daniel P. Weyrauch
- Whalen Optical Labs Inc
- Catherine J Whalen
All providers in Rockford, IL · Obstetrics & Gynecology 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 Jan 10, 2026. 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.