DR. BRYAN P TULLY (NPI# 1134442213) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134442213 |
| Entity Type | Individual |
| Full Name | DR. BRYAN P TULLY |
| Credential | M.D. |
| Practice Address |
5666 East State Street Rockford IL 61108-2425 |
| Practice Telephone | 8152262000 |
| Mailing Telephone | 8152262000 |
| Enumeration Date | 2010-03-03 |
| Last Update Date | 2011-02-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 036-126036 | IL | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | MT191660 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036126036 | 05 |
| Street Address |
5666 EAST STATE STREET |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61108-2425 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043280811 | Christopher M. Nielsen | Emergency Medicine | 5666 East State Street, Rockford, IL 61108-2425 | 2006-01-25 |
| 1912146119 | Kbclinic | Surgery | 5666 East State Street, Ambulatory Surgery Center/ Dr Blumofe, Rockford, IL 61108-2425 | 2009-02-11 |
| 1972706604 | Shylendra B Sreenivasappa | Internal Medicine | 5666 East State Street, Rockford, IL 61108-2425 | 2007-06-08 |
| 1164641791 | Iftekhar Y Ahmad | Radiology | 5666 East State Street, Rockford, IL 61108-2425 | 2007-04-24 |
| 1154453454 | Timothy P Coggin | Emergency Medicine | 5666 East State Street, Rockford, IL 61108-2472 | 2007-03-12 |
| 1356414890 | Vikram Gunnala | Internal Medicine | 5666 East State Street, Rockford, IL 61108-2472 | 2006-11-15 |
| 1295805174 | Binoy Kamal | Hospitalist | 5666 East State Street, Rockford, IL 61108-2472 | 2006-11-08 |
| 1700804028 | Azra Ali | Hospitalist | 5666 East State Street, Rockford, IL 61108-2472 | 2006-07-17 |
| 1447287495 | George T Bryan Jr. | Radiology | 5666 East State Street, Rockford, IL 61108-2472 | 2006-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952862617 | Isr Enterprises, Inc. | Homemaker | 129 Phelps Ave, Bldg 10, Ste 1008, Rockford, IL 61108 | 2019-03-26 |
| 1003306465 | Adrienne Nicole Black | Behavior Technician | 519 Woodland Dr, Woodland Dr, Rockford, IL 61108 | 2018-05-11 |
| 1184085201 | Integrative Healing Center, LLC | Clinic/Center | 6019 Fincham Drive, Rockford, IL 61108 | 2016-03-17 |
| 1730547936 | Perryville Dentist PC | Dentist | 845 S Perryville Rd, Unit 119, Rockford, IL 61108 | 2016-02-02 |
| 1023489853 | Nicole Ping Ticknor | Counselor | 433 S. Phelps Ave., Suite 2, Rockford, IL 61108 | 2015-10-20 |
| 1275940348 | Northwest Home Care, Inc. | Home Health | 1437 S. Bell School Road, Suite 7, Rockford, IL 61108 | 2014-07-21 |
| 1487072922 | Alecia Greenlee | Psychiatry & Neurology | Rosecrance Community Mental Health, 3815 Harrison Avenue, Rockford, IL 61108 | 2014-04-02 |
| 1871925446 | Maria Laura Gustafson | Interpreter | 3208 Wesleyan Ave., Rockford, IL 61108 | 2013-08-06 |
| 1346582822 | Joseph Peevey | Pathology | 5666 E State Street, Department of Pathology, Rockford, IL 61108 | 2013-03-21 |
| 1134466923 | James Henry Peck | Hearing Instrument Specialist | 2424 Charles St, Rockford, IL 61108 | 2013-01-14 |
| Find all providers in zip 61108 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962002832 | Coleman Clinic, Inc. | Internal Medicine | 1893 Daimler Rd Ste A, Rockford, IL 61112-1081 | 2020-10-29 |
| 1073167664 | Swedishamerican Hospital | Internal Medicine | 3505 N Bell School Road, Rockford, IL 61114 | 2019-07-31 |
| 1376077453 | Spectrum Health Primary Care Partners | Internal Medicine | 8501 Meadowcreek Dr, Rockford, MI 49341 | 2017-04-17 |
| 1871838656 | Takuo Sonoda | Internal Medicine | 729 Self Hollow Rd, Rockford, TN 37853-3413 | 2012-12-04 |
| 1912216284 | Irene Boswell Md PC | Internal Medicine | 7445 Newburg Rd, Suite 103, Rockford, IL 61108-4443 | 2010-10-04 |
| 1326271743 | Syed Muhammad Murtaza Zam Rizvi | Internal Medicine | 1340 Charles St Ste 405, Rockford, IL 61104-2200 | 2009-09-02 |
| 1679714216 | John Martin Roska | Internal Medicine | 1711 Shaw Woods Dr., Rockford, IL 61107-1725 | 2009-03-11 |
| 1457515280 | Carl Gerald Sundahl | Internal Medicine | 4519 Old Knoxville Hwy, Rockford, TN 37853-3023 | 2008-07-10 |
| 1497845135 | Humaira Bari | Internal Medicine | 2400 N. Rockton Avenue, Rockford, IL 61103 | 2006-10-13 |
| 1629176060 | Christine Judith Simaytis | Internal Medicine | 4940 E State St Ste 3, Rockford, IL 61108-2271 | 2006-09-20 |
| 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.