TONYA L TIDWELL (NPI# 1356850739) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356850739 |
| Entity Type | Individual |
| Full Name | TONYA L TIDWELL |
| Practice Address |
4282 E Rockton Rd Roscoe IL 61073-7420 |
| Mailing Address |
Po Box 1567 Rockford IL 61110-0067 |
| Practice Telephone | 7796969000 |
| Mailing Telephone | 7796967150 |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2017-10-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 041316348 | IL | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
209016801 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558660472 | Tonya Jean Tidwell | Physician Assistant | 1025 Marsh St, Mankato, MN 56001 | 2011-03-17 |
| Street Address |
4282 E ROCKTON RD |
| City | ROSCOE |
| State | IL |
| Zip Code | 61073-7420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134168586 | Gayle R Crays | Family Medicine | 4282 E Rockton Rd, Roscoe, IL 61073 | 2006-06-04 |
| 1437719291 | Dakota L Felckowski | Nurse Practitioner | 4282 E Rockton Rd, Roscoe, IL 61073-7420 | 2019-06-14 |
| 1295188803 | Nicole M Milani | Registered Nurse | 4282 E Rockton Rd, Roscoe, IL 61073-7420 | 2016-07-19 |
| 1386054062 | Swedishamerican Hospital | Internal Medicine | 4282 E Rockton Rd, Roscoe, IL 61073 | 2014-05-02 |
| 1841600715 | Amanda Huber | Registered Nurse | 4282 E Rockton Rd, Roscoe, IL 61073 | 2014-05-01 |
| 1770915589 | Syeda Roshan | Podiatrist | 4282 E Rockton Rd, Roscoe, IL 61073 | 2013-08-02 |
| 1922395763 | Jeffrey David Gurtizen | Family Medicine | 4282 E Rockton Rd, Roscoe, IL 61073 | 2011-06-30 |
| 1902035777 | Manika Bhateja | Pediatrics | 4282 E Rockton Rd, Roscoe, IL 61073 | 2009-07-14 |
| 1598701088 | Tarek Samir Harb | Obstetrics & Gynecology | 4282 E Rockton Rd, Roscoe, IL 61073 | 2006-06-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396234746 | Zachary J Rio | Physical Therapist | 4675 Bluestem Rd Ste 1, Roscoe, IL 61073 | 2018-05-01 |
| 1548702954 | Vicki Foti | Registered Nurse | 4828 Rockton Road, Roscoe, IL 61073 | 2016-11-16 |
| 1174074975 | James B Garrison | Social Worker | 11447 2nd St, Ste 9b, Roscoe, IL 61073 | 2016-10-18 |
| 1932457355 | Annie Pamela Stephens | Chiropractor | 11673 Main St., Roscoe, IL 61073 | 2012-08-15 |
| 1255602819 | Trent Michael Hippard | Chiropractor | 15724 B Elevator Rd, Roscoe, IL 61073 | 2012-01-13 |
| 1689856437 | Martha M Muldowney | Dentist | 5464 Pine Lane, Roscoe, IL 61073 | 2007-12-04 |
| 1396885794 | Richard Scott Newcomb | Optometrist | 11710 Main St Suite 2, Roscoe, IL 61073 | 2007-02-07 |
| 1356459754 | Margaret Allensworth Franklin | Counselor | 9830 Double Ditch Circle, Roscoe, IL 61073 | 2006-08-26 |
| 1811002660 | Cjn Therapy Services LLC | Counselor | 5334 Williams Drive, Roscoe, IL 61073 | 2006-08-20 |
| 1033142575 | Trina Renee Morgan | Chiropractor | 5724 B Elevator Rd, Roscoe, IL 61073 | 2006-07-08 |
| Find all providers in zip 61073 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861463325 | Esther Masat Preszler | Nurse Practitioner | 206 W Merrill Ave, Roscoe, SD 57471-0260 | 2006-01-31 |
| 1710535950 | Melissa Nicole Normoyle | Nurse Practitioner | 5000 Prairie Rose Dr, Roscoe, IL 61073-7792 | 2019-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538760277 | Jennifer Michelle Kennedy | Nurse Practitioner | 3006 Lakeview Dr, Metropolis, IL 62960-3119 | 2020-11-07 |
| 1881295541 | Britney Julia Durst | Nurse Practitioner | 5905 N Prospect Rd, Peoria, IL 61614-4311 | 2020-11-07 |
| 1952902884 | Julia Ann Gottschalk | Nurse Practitioner | 1979 Mcdowell Rd, Unit 103, Naperville, IL 60563 | 2020-11-06 |
| 1932700911 | Laura Ivette Portillo | Nurse Practitioner | 2727 N Marmora Ave, Chicago, IL 60639-1219 | 2020-11-05 |
| 1265033385 | Carolle M Derradji | Nurse Practitioner | 3256 W Potomac Ave, Chicago, IL 60651-2411 | 2020-11-04 |
| 1104427293 | Katie Michelle O'halloran | Nurse Practitioner | 5841 S Maryland Ave # E500, Chicago, IL 60637-1443 | 2020-11-04 |
| 1598365140 | Caitlyn Windsor | Nurse Practitioner | 24525 Grange Rd, Geneseo, IL 61254-8429 | 2020-10-31 |
| 1578163515 | Deanna Bassette | Nurse Practitioner | 243 E 31st St Apt 401, Chicago, IL 60616-5212 | 2020-10-29 |
| 1891395745 | Vrunda Shah Patel | Nurse Practitioner | 933 W Van Buren St Apt 502, Chicago, IL 60607-3583 | 2020-10-29 |
| 1346840337 | Catherine Suh | Nurse Practitioner | 1380 Marcy Ln, Wheeling, IL 60090-4422 | 2020-10-28 |
| Find all providers with the same taxonomy | ||||
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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.