PHYSICIAN ASSOCIATES LIMITED (NPI# 1013930353) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013930353 |
| Entity Type | Organization |
| Organization Name | PHYSICIAN ASSOCIATES LIMITED |
| Other Organization Name | D/B/A CHERRY VALLEY MEDICAL CLINIC |
| Practice Address |
1848 Daimler Rd Rockford IL 61112-1019 |
| Practice Telephone | 8152292500 |
| Practice Fax Number | 8153989587 |
| Mailing Telephone | 8152292500 |
| Mailing Fax Number | 8153161881 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2008-08-13 |
| Authorized Official Name | DR. THOMAS L MICHALSEN (PRESIDENT) |
| Authorized Official Telephone | 8152292500 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| D/B/A Cherry Valley Medical Clinic | Doing Business As Name - Organization |
| Street Address |
1848 DAIMLER RD |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61112-1019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790741049 | Mark Edwin Carlson | Specialist | 1848 Daimler Rd, Rockford, IL 61112-1019 | 2006-04-25 |
| 1811303217 | Kelly L Magoon | Physician Assistant | 1848 Daimler Rd, Rockford, IL 61112-1019 | 2014-07-07 |
| 1649444548 | Regional Cardiology Consultants Ltd | Specialist | 1848 Daimler Rd, Rockford, IL 61112-1019 | 2008-04-22 |
| 1366560773 | Catherine L Blake | Nurse Practitioner | 1848 Daimler Rd, Rockford, IL 61112-1019 | 2007-03-26 |
| 1750450243 | Vanessa Ann Dal Pra Wochner | Physical Therapist | 1848 Daimler Rd, Rockford, IL 61112-1019 | 2006-11-07 |
| 1245342666 | Carlson Orthopedic Clinic Sc | Specialist | 1848 Daimler Rd, Rockford, IL 61112-1019 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215213475 | Matthew Caleb Beary | Physical Therapist | 1545 Temple Lane, Rockford, IL 61112 | 2011-11-01 |
| 1730469206 | Herman Chen | Pharmacist | 2206 Barnes Blvd, Rockford, IL 61112 | 2011-08-27 |
| 1598850273 | Charles W Matty | Dentist | 1855 Daimler Rd, Rockford, IL 61112 | 2006-10-04 |
| 1942317607 | James Edward Nijoka | Dentist | 1855 Daimler Road, Rockford, IL 61112 | 2006-08-25 |
| 1053366591 | Vincent R Facchiano | Optometrist | E265 Cherryvale Mall, Rockford, IL 61112 | 2006-05-23 |
| 1780616029 | Daniel Gordon Thorstenson | Chiropractor | 1877 Daimler Rd, Rockford, IL 61112-1005 | 2006-07-07 |
| 1760800221 | Brock Stephen Field | Chiropractor | 1877 Daimler Rd, Rockford, IL 61112-1005 | 2014-04-02 |
| 1629366489 | Craig Anthony Stear Jr. | Chiropractor | 1877 Daimler Rd, Rockford, IL 61112-1005 | 2011-07-14 |
| 1104931427 | Hulsebus Rockford Chiropractic | Chiropractor | 1877 Daimler Rd, Rockford, IL 61112-1005 | 2006-08-19 |
| 1215958970 | Michael John Hulsebus | Chiropractor | 1877 Daimler Rd, Rockford, IL 61112-1005 | 2006-07-21 |
| Find all providers in zip 61112 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710257787 | Rudolf Vedo | General Practice | 5833 Nebeshone Ln, Rockford, IL 61103-8928 | 2012-01-09 |
| 1952670911 | Dr Patel Sc | General Practice | 6090 Strathmoor Dr Ste 4, Rockford, IL 61107-5200 | 2011-12-21 |
| 1295718641 | Jamil Hussain | General Practice | 6090 Strathmoor Dr, Rockford, IL 61107-6628 | 2005-11-21 |
| 1891294195 | Amanda Lynn Halvorson | General Practice | 5970 Churchview Dr, Rockford, IL 61107-2574 | 2018-02-02 |
| 1174885107 | Rockford Pain Management Ltd | General Practice | 6451 E Riverside Blvd, Suite 101, Rockford, IL 61114-4421 | 2012-06-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.