SWEDISHAMERICAN HOSPITAL (NPI# 1417018110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1417018110 |
Entity Type | Organization |
Organization Name | SWEDISHAMERICAN HOSPITAL |
Other Organization Name | SA BELVIDERE CLINIC |
Practice Address |
1700 Henry Luckow Ln Belvidere IL 61008 |
Mailing Address |
Po Box 78866 Milwaukee WI 53278-8866 |
Practice Telephone | 7796968650 |
Enumeration Date | 2006-12-13 |
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 | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
Allopathic & Osteopathic Physicians | ||
N | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers | ||
N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | CLIA | 14D0875979 | 01 |
Other Name | Type Code |
---|---|
SA Belvidere 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 |
1700 HENRY LUCKOW LN |
City | BELVIDERE |
State | IL |
Zip Code | 61008 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457373946 | Mary Simmons | Family Medicine | 1700 Henry Luckow Ln, Belvidere, IL 61008 | 2006-07-24 |
1578129987 | Tracy A Palmer | Registered Nurse | 1700 Henry Luckow Ln, Belvidere, IL 61008-1702 | 2019-05-13 |
1184151177 | Anne T Cunningham | Registered Nurse | 1700 Henry Luckow Ln, Belvidere, IL 61008-1702 | 2017-05-22 |
1184079451 | Amanda L Ritter | Nurse Practitioner | 1700 Henry Luckow Ln, Belvidere, IL 61008 | 2016-04-25 |
1104259894 | Erica J Hoyer | Registered Nurse | 1700 Henry Luckow Ln, Belvidere, IL 61008 | 2013-08-16 |
1043554918 | Diana E Schultz | Nurse Practitioner | 1700 Henry Luckow Ln, Belvidere, IL 61008 | 2012-11-16 |
1528374196 | Michael David Corcoran | Podiatrist | 1700 Henry Luckow Ln, Belvidere, IL 61008 | 2010-08-20 |
1104146539 | Andrea Nicole Giamalva | Family Medicine | 1700 Henry Luckow Ln, Belvidere, IL 61008 | 2010-06-08 |
1093950941 | Amanda Jo Bush | Obstetrics & Gynecology | 1700 Henry Luckow Ln, Belvidere, IL 61008 | 2008-12-06 |
1619125317 | Cassandra Lopez | Family Medicine | 1700 Henry Luckow Ln, Belvidere, IL 61008 | 2008-09-05 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902322944 | Lynsie Merry | Speech-Language Pathologist | 919 E. Sixth St., Belvidere, IL 61008 | 2017-08-22 |
1023379773 | Dylen Adair Larsen | Technician/Technologist | 521 South Street, Suite 1, Belvidere, IL 61008 | 2012-05-30 |
1376665224 | Ultrasound of Belvidere LLC | Radiologic Technologist | 1006 Logan Avenue, Belvidere, IL 61008 | 2007-04-04 |
1992845093 | Vicki Marie Harrison | Chiropractor | 301 North State Street, Belvidere, IL 61008 | 2007-02-07 |
1316007859 | Drs Drake Ltd | Dentist | 515 Pearl Street, Belvidere, IL 61008 | 2006-12-12 |
1194898015 | Family Optical Centre Inc | Optometrist | 304 No State St, Belvidere, IL 61008 | 2006-11-16 |
1134172166 | Gabriel John Javurek | Chiropractor | 1800 Logan Ave, Belvidere, IL 61008 | 2006-05-19 |
1437642535 | Bailey A Bolwerk | Physical Therapist | 1731 Henry Luckow Ln, Belvidere, IL 61008 | 2018-06-13 |
1447480033 | Swedishamerican Hospital | Internal Medicine | 1625 S State St, Belvidere, IL 61008 | 2009-07-17 |
1225200579 | Elaine Carlson Drake | Dentist | 515 Pearl Street, Belvidere, IL 61008 | 2008-03-27 |
Find all providers in zip 61008 |
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 |
---|---|---|---|---|
1033380514 | Preston Scott Medical Group | Family Medicine | 1906 Pierce Ct, Belvidere, IL 61008-1742 | 2008-03-12 |
1144424847 | L Robert Warren Md LLC | Family Medicine | 205 Cadillac Ct Ste 6, Belvidere, IL 61008-1733 | 2007-06-14 |
1912080912 | William Sandoval | Family Medicine | 1747 Henry Luckow Ln, Belvidere, IL 61008-1702 | 2006-10-23 |
1083700868 | John Patrick Fritz | Family Medicine | 500 Greenwich St, Belvidere, NJ 07823-1409 | 2006-10-05 |
1003820465 | John V Bernard | Family Medicine | 526 Water Street, Belvidere, NJ 07823 | 2006-07-28 |
1457373946 | Mary Simmons | Family Medicine | 1700 Henry Luckow Ln, Belvidere, IL 61008 | 2006-07-24 |
1699708636 | Therese Marie Lucietto-sieradzki | Family Medicine | 205 Cadillac Ct Ste 7, Belvidere, IL 61008-1733 | 2006-07-09 |
1235182288 | Saint Anthony Medical Center | Family Medicine | 143 Kishwaukee St, Belvidere, IL 61008-3507 | 2006-05-19 |
1437139896 | Shin Chen | Family Medicine | 1003 Logan Ave, Belvidere, IL 61008-3955 | 2006-01-20 |
1558341933 | L Robert Warren | Family Medicine | 205 Cadillac Ct, Belvidere, IL 61008-1733 | 2006-01-20 |
Find all providers in BELVIDERE |
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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.