AMANDA MACKE (NPI# 1407309941) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1407309941 |
Entity Type | Individual |
Full Name | AMANDA MACKE |
Credential | APN |
Practice Address |
1200 West State Street Rockford IL 61102-2112 |
Practice Telephone | 8154901600 |
Practice Fax Number | 8154901881 |
Mailing Telephone | 8154901600 |
Mailing Fax Number | 8154901881 |
Enumeration Date | 2016-08-02 |
Last Update Date | 2020-01-16 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
209013183 | IL | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
1200 WEST STATE STREET |
City | ROCKFORD |
State | IL |
Zip Code | 61102-2112 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750675872 | Heather Nicole Sharp | Nurse Practitioner | 1200 West State Street, Rockford, IL 61102-2112 | 2011-06-06 |
1730166323 | Crusader Central Clinic Association | Dentist | 1200 West State Street, Rockford, IL 61102-2112 | 2005-12-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205115383 | Renee Lynn Keeney | Advanced Practice Midwife | 1200 W. State Street, Crusader Community Health, Rockford, IL 61102 | 2011-08-08 |
1689895906 | Linda Lou O'reilly | Local Education Agency (LEA) | 1515 S. Meridian Road, Rockford, IL 61102 | 2007-05-02 |
1801012992 | Jennifer Anne Boyd | Developmental Therapist | Nia 1515 S. Meridian Rd., Rockford, IL 61102 | 2007-04-17 |
1447751623 | Cynthia Uwase | Dentist | 1200 W State St, Rockford, IL 61102 | 2018-02-23 |
1033591847 | Jithinraj Edakkanambeth Varayil | Family Medicine | 1200 W State St, Rockford, IL 61102 | 2015-06-29 |
1194106849 | Naomi Thompson | Family Medicine | 1200 W State St, Rockford, IL 61102 | 2015-06-17 |
1811377617 | Serene Antoinette Bethune | Family Medicine | 1200 W State St, Rockford, IL 61102 | 2015-06-05 |
1013188408 | Gary Patrick Fernando | Pediatrics | 1200 W State St, Rockford, IL 61102 | 2008-03-13 |
1265602130 | Martin A Ganan | Pharmacist | 1200 W State St, Pharmacy, Rockford, IL 61102 | 2008-03-07 |
1609173434 | Kellie J Gibbons | Registered Nurse | 650 W State Street, Winnebago County Jail Medical Unit, Rockford, IL 61102-0000 | 2011-02-14 |
Find all providers in zip 61102 |
Taxonomy Code | 363LP0200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Pediatrics |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750675872 | Heather Nicole Sharp | Nurse Practitioner | 1200 West State Street, Rockford, IL 61102-2112 | 2011-06-06 |
1952387789 | Lori Lynn Thompson | Nurse Practitioner | 826 N Main St, Rockford, IL 61103-6906 | 2005-12-22 |
1780680827 | Barbara B Morgan | Nurse Practitioner | 1200 W State St, Rockford, IL 61102-2112 | 2005-06-23 |
1043850068 | Lauren E Bell | Nurse Practitioner | 8201 E Riverside Blvd, Rockford, IL 61114-2300 | 2020-01-07 |
1043785793 | Rachel Lee Danks | Nurse Practitioner | 6861 Villagreen Vw, Rockford, IL 61107-5639 | 2018-10-09 |
1114464765 | Amanda M Bustle | Nurse Practitioner | 1200 W State St, Rockford, IL 61102-2112 | 2017-01-20 |
1316304744 | Kristin Vanderwell | Nurse Practitioner | 6050 Northland Dr Ne Ste 200, Rockford, MI 49341 | 2016-01-15 |
1982004461 | Jennifer Helen Benters | Nurse Practitioner | 1200 W State St, Rockford, IL 61102-2112 | 2014-09-03 |
1023446770 | Kerin Cummins | Nurse Practitioner | 1200 W State St, Rockford, IL 61102-2112 | 2013-10-16 |
1891942710 | Shannon M Krueger | Nurse Practitioner | 2300 N Rockton Ave, Rockford, IL 61103-3619 | 2008-08-21 |
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.