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CRUSADER COMMUNITY HEALTH
NPI 1417203191
Clinic/Center - Federally Qualified Health Center (FQHC) in Rockford, IL

Active since July 31, 2012
1200 W STATE ST, ROCKFORD, IL 61102(815) 490-1600(815) 490-1625 Get Directions Write a Review

NPPES record last updated: February 25, 2022. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Feb 25, 2022, Mar 19, 2019 (2 updates tracked since 2019).

About Crusader Community Health NPPES

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

CRUSADER COMMUNITY HEALTH (NPI 1417203191) is a healthcare organization registered as a federally qualified health center (fqhc) in Rockford, Illinois and active in the NPI registry since July 2012. The organization lists Samuel Miller, President And Ceo, as its authorized official.

NPPES Registry Identity

NPI1417203191
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameCRUSADERS CENTRAL CLINIC ASSOCIATION
Location Address1200 W STATE STRockford, IL 61102-2112
Mailing Address1200 W State StRockford, IL 61102-2112 · (815) 490-1600 · Fax (815) 490-1845
Phone(815) 490-1600
Fax(815) 490-1625
Organization SubpartYes
Authorized OfficialSamuel MillerPresident And Ceo · (815) 490-1737
Enumeration DateJuly 31, 2012
Last NPPES UpdateFebruary 25, 20222 updates tracked since enumeration
NPPES CertifiedFebruary 25, 2022
✔ NPI 1417203191 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
1200 W STATE ST, Rockford, IL 61102
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Other Names 1

Doing Business AsCrusader Community Health

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CARYN ANN RUZIC APRN
Nurse Practitioner (Family)
1200 W STATE ST
ROCKFORD, IL 61102
Winnebago County (815) 490-1600
DR. JOHN WALL MD
Family Medicine
1200 W STATE ST
ROCKFORD, IL 61102
Winnebago County (815) 490-1600
DR. ADEKOLA ABIOUDUN ASHAYE MD
Internal Medicine
1200 W STATE ST
ROCKFORD, IL 61102
Winnebago County (815) 490-1600
DR. GARY PATRICK FERNANDO MD
Pediatrics
1200 W STATE ST
ROCKFORD, IL 61102
Winnebago County (815) 490-1600
CRISTINA DIVENTI LSW
Social Worker
1200 W STATE ST
ROCKFORD, IL 61102
Winnebago County (815) 490-1600
CORNITA CANNON M.D.
Obstetrics & Gynecology
1200 W STATE ST
ROCKFORD, IL 61102
Winnebago County (815) 490-1600
LAURA PEREZ CNM, APRN
Advanced Practice Midwife
1200 W STATE ST
ROCKFORD, IL 61102
Winnebago County (815) 490-1600
KERIN CUMMINS APN
Nurse Practitioner (Family)
1200 W STATE ST
ROCKFORD, IL 61102
Winnebago County (815) 490-1600

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 Crusaders Central Clinic Association's NPI number?

The NPI number for Crusaders Central Clinic Association is 1417203191. It was assigned to this organization in the NPPES registry on July 31, 2012. The provider is doing business as Crusader Community Health.

Where is Crusaders Central Clinic Association located?

Crusaders Central Clinic Association is located at 1200 W State St, Rockford, IL 61102. The listed phone number is (815) 490-1600.

What is Crusaders Central Clinic Association's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

When was this NPI record last updated?

The NPPES record for Crusaders Central Clinic Association was last updated on February 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.