SA BELVIDERE CLINIC
NPI 1417018110
Family Medicine in Belvidere, IL

Active since December 13, 2006
1700 HENRY LUCKOW LN, BELVIDERE, IL 61008(779) 696-8650 Get Directions Write a Review

NPPES record last updated: July 12, 2018. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Sa Belvidere Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SA BELVIDERE CLINIC (NPI 1417018110) is a healthcare organization registered as a family medicine in Belvidere, Illinois and active in the NPI registry since December 2006. The organization lists Don Daniels, Vp, as its authorized official.

NPPES Registry Identity

NPI1417018110
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSWEDISHAMERICAN HOSPITAL
Location Address1700 HENRY LUCKOW LNBelvidere, IL 61008
Mailing AddressPo Box 78866Milwaukee, WI 53278-8866
Organization SubpartNo
Authorized OfficialDon DanielsVp · (815) 966-2084
Enumeration DateDecember 13, 2006
Last NPPES UpdateJuly 12, 2018
✔ NPI 1417018110 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedObstetrics & Gynecology · GynecologyTaxonomy 207VG0400X
Also ListedPodiatristTaxonomy 213E00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
1700 HENRY LUCKOW LN, Belvidere, IL 61008

Other Names 1

Other NameSa Belvidere Clinic

Other Identifiers 2

Other14D0875979IL · Clia
Other=========034IL · Tricare

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sa Belvidere Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by February 28, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateIllinoisEnrollment IDO20031215000012Non-DME Part B · Clinic/Group PracticeDue dateFebruary 28, 2027
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

474

Medicare enrollment records show 474 clinicians reassign Medicare billing to Sa Belvidere Clinic, which bills Medicare for the services they deliver. Of these, 15 practice at this address and 146 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 39

Nurse Practitioner134
Family Practice63
Obstetrics/Gynecology30
General Surgery23
Pediatric Medicine19
Vascular Surgery18
Internal Medicine15
Cardiovascular Disease (Cardiology)14
31 other specialties158

Nearest to this location (20)

See all 474
Nurse Practitioner
NPI 1073021762
1700 HENRY LUCKOW LN
Belvidere, IL 61008
(779) 696-8650
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1841083342
1700 HENRY LUCKOW LN
Belvidere, IL 61008
(779) 696-8650
✔ PECOS✔ Accepts MedicareSame address
Podiatry
NPI 1528374196
1700 HENRY LUCKOW LN
Belvidere, IL 61008
(779) 696-8650
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1184151177
1700 HENRY LUCKOW LN
Belvidere, IL 61008
(779) 696-8650
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1023239258
1700 HENRY LUCKOW LN
Belvidere, IL 61008
(779) 696-8650
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1922882562
1700 HENRY LUCKOW LN
Belvidere, IL 61008
(779) 696-8650
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1104259894
1700 HENRY LUCKOW LN
Belvidere, IL 61008
(779) 696-8650
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1184079451
1700 HENRY LUCKOW LN
Belvidere, IL 61008
(779) 696-8650
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1427210319
1700 HENRY LUCKOW LN
Belvidere, IL 61008
(779) 696-8650
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1659908879
1700 HENRY LUCKOW LN
Belvidere, IL 61008
(779) 696-8650
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1407657026
1700 HENRY LUCKOW LN
Belvidere, IL 61008
(779) 696-8650
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1619125317
1700 HENRY LUCKOW LN
Belvidere, IL 61008
(779) 696-8650
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1134818149
1700 HENRY LUCKOW LN
Belvidere, IL 61008
(779) 696-8650
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1700308913
1700 HENRY LUCKOW LN
Belvidere, IL 61008
(779) 696-8650
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1457373946
1700 HENRY LUCKOW LN
Belvidere, IL 61008
(779) 696-8650
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1841619863
1625 S STATE ST
Belvidere, IL 61008
(610) 984-5640
✔ PECOS✔ Accepts Medicare2.5 mi
Diagnostic Radiology
NPI 1528087913
1322 TUNEBERG PKWY
Belvidere, IL 61008
(847) 445-4262
✔ PECOS✔ Accepts Medicare2.8 mi
Nurse Practitioner
NPI 1568228831
1663 BELVIDERE RD
Belvidere, IL 61008
(815) 544-0040
✔ PECOS✔ Accepts Medicare3.1 mi
Vascular Surgery
NPI 1720107261
8201 E RIVERSIDE BLVD
Rockford, IL 61114
(815) 971-7000
✔ PECOS✔ Accepts Medicare5.8 mi
Nurse Practitioner
NPI 1649781741
3535 N BELL SCHOOL RD
Rockford, IL 61114
(779) 696-9400
✔ PECOS✔ Accepts Medicare6.0 mi
See all 474 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Swedishamerican Hospital's NPI number?

The NPI number for Swedishamerican Hospital is 1417018110. It was assigned to this organization in the NPPES registry on December 13, 2006. The provider is also known as Sa Belvidere Clinic.

Where is Swedishamerican Hospital located?

Swedishamerican Hospital is located at 1700 Henry Luckow Ln, Belvidere, IL 61008. The listed phone number is (779) 696-8650.

What is Swedishamerican Hospital's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Swedishamerican Hospital enrolled in Medicare?

Yes. Swedishamerican Hospital is registered in the Medicare PECOS enrollment system.

When is Swedishamerican Hospital's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Illinois, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Swedishamerican Hospital?

According to the CMS Revalidation Reassignment List (October 2026 release), 474 clinicians in 39 Medicare specialties reassign their Medicare billing to Swedishamerican Hospital. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (134), Family Practice (63) and Obstetrics/Gynecology (30). Of these, 15 practice at this address and 146 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Swedishamerican Hospital was last updated on July 12, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.