SWEDISHAMERICAN HOSPITAL (NPI# 1386054062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386054062 |
| Entity Type | Organization |
| Organization Name | SWEDISHAMERICAN HOSPITAL |
| Other Organization Name | SA STATELINE CLINIC |
| Practice Address |
4282 E Rockton Rd Roscoe IL 61073 |
| Mailing Address |
Po Box 78866 Milwaukee WI 53278-8866 |
| Practice Telephone | 7796969000 |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2018-07-12 |
| Authorized Official Name | DON DANIELS (VP) |
| Authorized Official Telephone | 8159662084 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| N | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | TRICARE SUFFIX # | 082 | 01 |
| Other Name | Type Code |
|---|---|
| SA Stateline Clinic | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073167664 | Swedishamerican Hospital | Internal Medicine | 3505 N Bell School Road, Rockford, IL 61114 | 2019-07-31 |
| 1699216564 | Swedishamerican Hospital | Nutritionist | 1415 E. State St., Lower Level A3, Rockford, IL 61104 | 2017-03-13 |
| 1114470945 | Swedishamerican Hospital | Pediatrics | 461 N Mulford Rd Ste 4, Rockford, IL 61107-5165 | 2016-07-28 |
| 1376950485 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 200, Rockford, IL 61104 | 2014-07-21 |
| 1093139909 | Swedishamerican Hospital | Surgery | 1639 N Alpine Rd Ste 400, Rockford, IL 61107 | 2014-02-12 |
| 1740596808 | Swedishamerican Hospital | Surgery | 6533 Lexus Dr, Rockford, IL 61108 | 2010-08-27 |
| 1689729535 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 100, Rockford, IL 61104 | 2007-01-23 |
| 1225199961 | Swedishamerican Hospital | Nurse Practitioner | 230 W Blackhawk Dr, Byron, IL 61010 | 2006-12-13 |
| 1285720763 | Swedishamerican Hospital | Durable Medical Equipment & Medical Supplies | 2550 Charles St Ste A, Rockford, IL 61108-1673 | 2006-10-04 |
| 1962451732 | Swedishamerican Hospital | Pediatrics | 2550 Charles St, Rockford, IL 61108 | 2006-05-09 |
| Street Address |
4282 E ROCKTON RD |
| City | ROSCOE |
| State | IL |
| Zip Code | 61073 |
| 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 |
| 1356850739 | Tonya L Tidwell | Registered Nurse | 4282 E Rockton Rd, Roscoe, IL 61073-7420 | 2017-09-28 |
| 1295188803 | Nicole M Milani | Registered Nurse | 4282 E Rockton Rd, Roscoe, IL 61073-7420 | 2016-07-19 |
| 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 | 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 |
|---|---|---|---|---|
| 1942304456 | Katerina C Doronila-hughes | Family Medicine | 4682 E Rockton Rd, Suite 102, Roscoe, IL 61073-7475 | 2006-09-13 |
| 1679684211 | Marchele A Bowen | Family Medicine | 5005 Hononegah Rd, Roscoe, IL 61073-8682 | 2006-08-31 |
| 1134168586 | Gayle R Crays | Family Medicine | 4282 E Rockton Rd, Roscoe, IL 61073 | 2006-06-04 |
| 1659635092 | Luan Elezi | Family Medicine | 5605 E Rockton Rd, Northpointe Clinic, Roscoe, IL 61073-7601 | 2012-06-29 |
| 1922395763 | Jeffrey David Gurtizen | Family Medicine | 4282 E Rockton Rd, Roscoe, IL 61073 | 2011-06-30 |
| 1962557678 | Swedishamerican Hospital | Family Medicine | 5005 Hononegah Rd, Roscoe, IL 61073-8682 | 2007-01-24 |
| 1922152990 | Swedishamerican Hospital | Family Medicine | 5005 Hononegah Rd, Roscoe, IL 61073-8682 | 2007-01-23 |
| 1437167277 | Marek S Bentkowski | Family Medicine | 5605 E. Rockton Road, Northpointe Clinic, Roscoe, IL 61073-7601 | 2006-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053911495 | Moataz Barkat | Family Medicine | 3315 W 66th Pl, Chicago, IL 60629-3427 | 2020-10-26 |
| 1558969964 | Nicole Kerner | Family Medicine | 310 Brandy Dr, Mackinaw, IL 61755-9707 | 2020-10-16 |
| 1285232991 | Healthy Medical Inc | Family Medicine | 535 N. East St., Suite A, Bradley, IL 60915 | 2020-10-14 |
| 1558976589 | Jasmine Ashley Fowler | Family Medicine | 2416 N Lotus Ave, Chicago, IL 60639-1435 | 2020-09-15 |
| 1790390805 | Kimberly Hannah Kupferberg | Family Medicine | 1103 Schaeffer Rd, Long Grove, IL 60047-5153 | 2020-09-15 |
| 1194330977 | Home Doctors for You | Family Medicine | 670 Illinois Blvd, Hoffman Est, IL 60169-3363 | 2020-09-09 |
| 1245844489 | Jovita Zalwango Nassolo | Family Medicine | 116 1/2 N Benton St Apt 2d, Woodstock, IL 60098-3272 | 2020-09-04 |
| 1720699176 | Healing Hands Resource Center Streator | Family Medicine | 2128 S Central Park Ave, Chicago, IL 60623-3113 | 2020-08-10 |
| 1417565755 | Ghr Total Health and Consulting | Family Medicine | 11336 Mckenna Dr, Frankfort, IL 60423-8096 | 2020-07-22 |
| 1285251892 | Soe Lwin Oo | Family Medicine | 1625 E 75th St # 1, Chicago, IL 60649-3603 | 2020-06-30 |
| 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.