AMANDA MACKE


Address: 1200 West State Street, Rockford, IL 61102-2112
Phone: 8154901600

AMANDA MACKE (NPI# 1407309941) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0200X Nurse Practitioner
Specialization: Pediatrics
209013183 IL Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1200 WEST STATE STREET
City ROCKFORD
State IL
Zip Code 61102-2112

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 363LP0200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Pediatrics

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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

Competitor

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City ROCKFORD
Zip Code 61102

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Dataset Information

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.

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