SHYAMAL MADHAVANI (NPI# 1346657558) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346657558 |
| Entity Type | Individual |
| Full Name | SHYAMAL MADHAVANI |
| Credential | D.O. |
| Practice Address |
1401 E State St Rockford IL 61104-2315 |
| Practice Telephone | (779) 696-4400 |
| Mailing Telephone | (779) 696-4400 |
| Enumeration Date | 2014-07-20 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036.143535 | IL | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 274346-223 | NY | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1000 Montauk Hwy, West Islip, NY 117954927 | 6313764163 | 6313763420 |
| Street Address |
1401 E STATE ST |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61104-2315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003899196 | Thomas Danko | Pediatrics | 1401 E State St, Rockford, IL 61104-2315 | 2005-11-22 |
| 1184232621 | Sound Physicians Emergency Medicine of Illinois LLC | Emergency Medicine | 1401 E State St, Rockford, IL 61104-2315 | 2020-07-21 |
| 1235764556 | Alexandra Paganis | Nurse Practitioner | 1401 E State St, Rockford, IL 61104-2315 | 2020-03-06 |
| 1538790266 | Sherri L Paprocki | Emergency Medicine | 1401 E State St, Rockford, IL 61104-2315 | 2020-01-31 |
| 1417593310 | Jason C Hipe | Registered Nurse | 1401 E State St, Rockford, IL 61104-2315 | 2019-11-26 |
| 1487298642 | Matthew Montgomery | Physical Therapist | 1401 E State St, Rockford, IL 61104-2315 | 2019-10-31 |
| 1265076541 | Sarah Kemp | Occupational Therapist | 1401 E State St, Rockford, IL 61104-2315 | 2019-10-30 |
| 1891341939 | Swedishamerican Hospital | Pharmacy | 1401 E State St, Rockford, IL 61104-2315 | 2019-08-14 |
| 1306408885 | Jonathan Ray Nelson | Physical Therapy Assistant | 1401 E State St, Rockford, IL 61104-2315 | 2019-07-03 |
| 1124680608 | Kirsten Sympson | Occupational Therapy Assistant | 1401 E State St, Rockford, IL 61104-2315 | 2019-07-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699216564 | Swedishamerican Hospital | Nutritionist | 1415 E. State St., Lower Level A3, Rockford, IL 61104 | 2017-03-13 |
| 1376950485 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 200, Rockford, IL 61104 | 2014-07-21 |
| 1871907774 | Oday Alsarraf | Psychiatry & Neurology | 1401 E State Street, Center for Mental Health, Swedish American Hospital, Rockford, IL 61104 | 2014-06-18 |
| 1962652339 | Children's Home and Aid | Community/Behavioral Health | 424 7th St, Rockford, IL 61104 | 2008-09-23 |
| 1689729535 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 100, Rockford, IL 61104 | 2007-01-23 |
| 1790873016 | David J Schleicher | Obstetrics & Gynecology | 209 9th St Ste 200, Rockford, IL 61104 | 2006-10-11 |
| 1013026624 | Thomas Ryan Moss | Dentist | 1415 E State Street, Rockford, IL 61104 | 2006-08-29 |
| 1366452096 | Arturo Santiago Manas | Obstetrics & Gynecology | 1415 E State St Fl 8, Rockford, IL 61104 | 2006-08-08 |
| 1245263268 | William John Stout | Physician Assistant | 1401 E State Street, Rockford, IL 61104 | 2006-07-10 |
| 1689604969 | Prabha Chand Dosi | Pediatrics | 1401 E. State Street, Rockford, IL 61104 | 2006-07-03 |
| Find all providers in zip 61104 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851910350 | Charity L Soles | Family Medicine | 4134 Ashwinton Way, Rockford, IL 61109-3273 | 2020-04-14 |
| 1306250543 | Camille Ryan | Family Medicine | 6050 Northland Dr Ne Ste 200, Rockford, MI 49341-9257 | 2014-06-16 |
| 1396991485 | Novella Ann Schafer | Family Medicine | 3719 Regal Ridge Circle, Rockford, IL 61114-6037 | 2008-08-08 |
| 1417139130 | Derek Lanier | Family Medicine | 8450 Brower Lake Rd Ne, Apt/suite, Rockford, MI 49341-9346 | 2007-12-04 |
| 1144414921 | Moses Godofredo Tomacruz | Family Medicine | 1502 Parkview Ave, Rockford, IL 61107-1821 | 2007-09-05 |
| 1508077165 | Robert Dejonge Do PC | Family Medicine | 350 Northland Dr Ne, Rockford, MI 49341-1401 | 2007-05-25 |
| 1902018641 | Julie Stark | Family Medicine | 3475 So Alpine Rd, Physicians Immediate Care, Rockford, IL 61109-2604 | 2007-05-04 |
| 1205976024 | Mohammed Khaleeluddin | Family Medicine | 1729 Oak Park Drive, Rockford, IL 61107-5510 | 2007-02-08 |
| 1134273238 | Swedishamerican Hosptial | Family Medicine | 3906 N Main St, Suite A, Rockford, IL 61103-1679 | 2007-01-23 |
| 1194897223 | Niccole Ranz | Family Medicine | 2222 E State St, Suite 209, Rockford, IL 61104-1573 | 2006-11-14 |
| 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.