MRS. LISA DIANE KEHOE (NPI# 1053615054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053615054 |
| Entity Type | Individual |
| Full Name | MRS. LISA DIANE KEHOE |
| Credential | IBCLC, RLC |
| Practice Address |
1745 Williamsburg Rd Rockford IL 61107-2445 |
| Practice Telephone | 8159884292 |
| Mailing Telephone | 8159884292 |
| Enumeration Date | 2011-01-05 |
| Last Update Date | 2011-01-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 11035024 | IL | Other Service Providers |
| Street Address |
1745 WILLIAMSBURG RD |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61107-2445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356952139 | Jessica Marie Tamayo Fernandez | Pharmacist | 1145 Alpine Rd, Rockford, IL 61107 | 2020-08-13 |
| 1467092379 | Unknown Safa Fatima | Student in an Organized Health Care Education/Training Program | Mercyhealth Mulford Clinic, 5970 Churchview Drive, Rockford, IL 61107 | 2020-01-08 |
| 1194367912 | Matt J Kriebs | Nurse Practitioner | 1235 N Mulford Rd Suite 103, Rockford, IL 61107 | 2019-10-14 |
| 1265962336 | Mary Golembeck | Nurse Practitioner | 7290 Argus Dr, Rockford, IL 61107 | 2017-06-12 |
| 1831644749 | Tessa Lee | Occupational Therapist | 3422 Lauderdale Ln, Rockford, IL 61107 | 2016-08-20 |
| 1942626965 | Elevated Health Essentials, LLC | Chiropractor | 124 N Water St Ste 204e, Rockford, IL 61107 | 2014-03-14 |
| 1093139909 | Swedishamerican Hospital | Surgery | 1639 N Alpine Rd Ste 400, Rockford, IL 61107 | 2014-02-12 |
| 1346676582 | Christopher Anthony Ziganto | Pharmacist | 494 Bienterra Trail #2, Rockford, IL 61107 | 2013-09-19 |
| 1023358272 | Lavanya Durairajan | Physical Therapist | 7358 Shiligton Dr, Rockford, IL 61107 | 2013-02-26 |
| 1851523146 | Great Smiles of Rockford | Durable Medical Equipment & Medical Supplies | 780 N. Mulfrord Road, Rockford, IL 61107 | 2009-08-20 |
| Find all providers in zip 61107 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134445489 | Sanford Bruce Mer | Specialist | 3008 Spring Creek Rd, Rockford, IL 61107-1061 | 2010-04-12 |
| 1225351935 | Rhiannon Marie Deyoung | Specialist | 8450 Algoma Ave Ne Ste Aaa, Rockford, MI 49341-7508 | 2010-03-09 |
| 1689900169 | Jacqueline Michele Sharp | Specialist | 2204 Arthur Ave, Rockford, IL 61101-5224 | 2009-10-19 |
| 1184869893 | Joseph Gerard Lynch | Specialist | 8081 Ravenrock Rd, Rockford, MN 55373-9394 | 2008-12-09 |
| 1548438344 | Helen Wiedemer Laib | Specialist | 4804 Innsbruck Dr, Rockford, IL 61114-7312 | 2008-02-14 |
| 1962609859 | Sandra Rebecca Hallman | Specialist | 6017 Abington Dr, Rockford, IL 61109-2757 | 2007-07-02 |
| 1558481366 | Mark Theodore Peterson | Specialist | 5712 Newburg Rd, Rockford, IL 61108-6707 | 2007-03-29 |
| 1801913769 | Megan D Lindley | Specialist | 610 Vale Ave, Rockford, IL 61107-4656 | 2007-03-24 |
| 1841335072 | Ob-gyn Associates (rockford) Ltd. | Specialist | 1016 Featherstone Road, Rockford Ambulatory Surgery Center, Rockford, IL 61107 | 2007-02-21 |
| 1376610600 | Susan K Fendler | Specialist | 6822 Cummins Dr, Rockford, IL 61114-8069 | 2006-11-30 |
| Find all providers in ROCKFORD | ||||
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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.