DR. GRACE BLITZER (NPI# 1053844852) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053844852 |
| Entity Type | Individual |
| Full Name | DR. GRACE BLITZER |
| Credential | MD |
| Practice Address |
2400 N Rockton Ave Rockford IL 61103-3655 |
| Practice Telephone | 8159716188 |
| Practice Fax Number | 8159689677 |
| Mailing Telephone | 8159716188 |
| Mailing Fax Number | 8159689677 |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2020-09-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0001X |
Radiology Specialization: Radiation Oncology |
71953-20 | WI | Allopathic & Osteopathic Physicians |
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
036153596 | IL | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1053844852 | 05 | |
| IL | 036153596 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8201 E Riverside Blvd, Rockford, IL 611142300 | 8159717000 | |
| 1000 Mineral Point Ave, Janesville, WI 535482982 | 6087566731 |
| Street Address |
2400 N ROCKTON AVE |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61103-3655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457357592 | Michael J Kikta | Surgery | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2005-06-23 |
| 1053950055 | Tina Longphee | Registered Nurse | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2019-12-23 |
| 1598227407 | Shahid Mohammad | Student in an Organized Health Care Education/Training Program | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2019-04-01 |
| 1265993109 | Sarah Elaine Robertson | Student in an Organized Health Care Education/Training Program | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2019-03-25 |
| 1770042525 | Vinita Patel | Student in an Organized Health Care Education/Training Program | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2019-03-19 |
| 1255890646 | Gilda Djabarzade | Student in an Organized Health Care Education/Training Program | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2019-03-15 |
| 1285103002 | Amy Lask | Nurse Practitioner | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2018-11-21 |
| 1477038743 | Michelle Harris | Advanced Practice Midwife | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2018-10-02 |
| 1134603095 | Sarah R Linder | Nurse Practitioner | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2018-09-17 |
| 1376022350 | Atiq Urrehman Khan | Psychiatry & Neurology | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2018-08-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598398497 | The Elitist Group | Home Health Aide | 2929 N Main Street, Rockford, IL 61103 | 2020-02-19 |
| 1972064194 | Mahita Bellamkonda | Student in an Organized Health Care Education/Training Program | 2400 North Rockton Avenue, Rockford, IL 61103 | 2019-03-29 |
| 1558538967 | Willows Health Center | Clinic/Center | 4143 Albright Lane, Rockford, IL 61103 | 2008-05-14 |
| 1497845135 | Humaira Bari | Internal Medicine | 2400 N. Rockton Avenue, Rockford, IL 61103 | 2006-10-13 |
| 1841385242 | Rachel Pawlowski | Occupational Therapist | 3616 N. Main Street, Rockford, IL 61103 | 2006-10-03 |
| 1417068438 | Alicia Anne Huntley | Midwife | 2400 Rockton Ave, Rockford, IL 61103 | 2006-08-31 |
| 1639190200 | Glendon Burress | Pediatrics | 2300 N. Rockton Ave., Rockford Health Physicians, Rockford, IL 61103 | 2006-07-21 |
| 1225065204 | Daniel William Johnson | Dentist | 519 Toner Av, Rockford, IL 61103 | 2006-06-27 |
| 1760472898 | Ronald Peter Oberfoell | Anesthesiology | 2400 North Rockton Ave, Rockford Health Physicians, Rockford, IL 61103 | 2005-10-28 |
| 1841752532 | Dipti Sabharwal | Student in an Organized Health Care Education/Training Program | 2400 N Rockton Avenue, Rockford, IL 61103 | 2019-04-02 |
| Find all providers in zip 61103 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730511379 | Swedishamerican Hospital | Radiology | 3535 N Bell School Rd, Rockford, IL 61114 | 2013-08-06 |
| 1477840320 | Maryam Hamidi | Radiology | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2011-06-29 |
| 1922394402 | Benjamin Y Durkee | Radiology | 3535 N Bell School Rd, Rockford, IL 61114 | 2011-06-23 |
| 1164641791 | Iftekhar Y Ahmad | Radiology | 5666 East State Street, Rockford, IL 61108-2425 | 2007-04-24 |
| 1134141773 | Virendra Saxena | Radiology | 1401 E State St, Rockford, IL 61104-2315 | 2006-07-24 |
| 1295753259 | Prakash Pedapati | Radiology | 3535 N Bell School Rd, Rockford, IL 61114 | 2006-07-18 |
| 1447287495 | George T Bryan Jr. | Radiology | 5666 East State Street, Rockford, IL 61108-2472 | 2006-06-27 |
| 1801839519 | Gregory M. Richards | Radiology | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2006-06-13 |
| 1336188705 | Joycelyn L. Speight | Radiology | 3535 N Bell School Rd, Rockford, IL 61114-6624 | 2006-06-04 |
| 1831184654 | Rockford Radiation Oncology Ltd | Radiology | 2400 N Rockton Ave, Dept Radiation Oncology, Rockford, IL 61103-3655 | 2005-09-19 |
| 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.