FREDRIC C. KULLBERG, M.D.S.C. (NPI# 1447364740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447364740 |
| Entity Type | Organization |
| Organization Name | FREDRIC C. KULLBERG, M.D.S.C. |
| Practice Address |
5668 E State St Suite B600 Rockford IL 61108-2490 |
| Practice Telephone | 8153977212 |
| Practice Fax Number | 8153972539 |
| Mailing Telephone | 8153977212 |
| Mailing Fax Number | 8153972539 |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2008-03-11 |
| Authorized Official Name | FREDRIC C. KULLBERG (PRESIDENT) |
| Authorized Official Telephone | 8153977212 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD | 101 00574 | 01 |
| Street Address |
5668 E STATE ST SUITE B600 |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61108-2490 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477553659 | Mark E Hastings | Orthopaedic Surgery | 5668 E State St, Suite 400, Rockford, IL 61108-2490 | 2005-07-28 |
| 1013453075 | Melissa L. Inman | Nurse Practitioner | 5668 E State St, Rockford, IL 61108-2464 | 2017-01-16 |
| 1326408436 | Victoria Mccoy | Nurse Practitioner | 5668 E State St, Rockford, IL 61108-2464 | 2016-03-02 |
| 1477975175 | Lonn E Brander Dds Ltd | Durable Medical Equipment & Medical Supplies | 5668 E State St, Suite 1100, Rockford, IL 61108-2490 | 2014-01-15 |
| 1447550884 | Tetsuya Takeuchi | Surgery | 5668 E State St, Rockford, IL 61108-2464 | 2010-11-02 |
| 1558686709 | Michael Anthony Hart | Surgery | 5668 E State St, Rockford, IL 61108-2464 | 2010-03-31 |
| 1285965905 | John Eric Player | Surgery | 5668 E State St, Suite 1000, Rockford, IL 61108-2464 | 2010-01-20 |
| 1568795441 | Denise M Nordenberg | Nurse Practitioner | 5668 E State St, Rockford, IL 61108-2464 | 2009-09-10 |
| 1063686848 | Dacia Aurelia Pickering | Surgery | 5668 E State St, #2, Rockford, IL 61108-2490 | 2008-04-14 |
| 1942485735 | Sameer Ansar | Internal Medicine | 5668 E State St, Suite 2000, Rockford, IL 61108-2490 | 2007-12-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952862617 | Isr Enterprises, Inc. | Homemaker | 129 Phelps Ave, Bldg 10, Ste 1008, Rockford, IL 61108 | 2019-03-26 |
| 1003306465 | Adrienne Nicole Black | Behavior Technician | 519 Woodland Dr, Woodland Dr, Rockford, IL 61108 | 2018-05-11 |
| 1184085201 | Integrative Healing Center, LLC | Clinic/Center | 6019 Fincham Drive, Rockford, IL 61108 | 2016-03-17 |
| 1730547936 | Perryville Dentist PC | Dentist | 845 S Perryville Rd, Unit 119, Rockford, IL 61108 | 2016-02-02 |
| 1023489853 | Nicole Ping Ticknor | Counselor | 433 S. Phelps Ave., Suite 2, Rockford, IL 61108 | 2015-10-20 |
| 1275940348 | Northwest Home Care, Inc. | Home Health | 1437 S. Bell School Road, Suite 7, Rockford, IL 61108 | 2014-07-21 |
| 1487072922 | Alecia Greenlee | Psychiatry & Neurology | Rosecrance Community Mental Health, 3815 Harrison Avenue, Rockford, IL 61108 | 2014-04-02 |
| 1871925446 | Maria Laura Gustafson | Interpreter | 3208 Wesleyan Ave., Rockford, IL 61108 | 2013-08-06 |
| 1346582822 | Joseph Peevey | Pathology | 5666 E State Street, Department of Pathology, Rockford, IL 61108 | 2013-03-21 |
| 1134466923 | James Henry Peck | Hearing Instrument Specialist | 2424 Charles St, Rockford, IL 61108 | 2013-01-14 |
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| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366552556 | Bharati P. Roy | Internal Medicine | 2300 N Rockton Ave, Rockford, IL 61103-3619 | 2006-08-30 |
| 1972617181 | Nadeem Hanif | Internal Medicine | 535 Roxbury Rd, Suite B600, Rockford, IL 61107-5076 | 2006-08-18 |
| 1780798801 | Nadeem Hanif, M.d.s.c. | Internal Medicine | 5668 E State St, Suite B600, Rockford, IL 61108-2490 | 2006-08-18 |
| 1568576734 | Theodore S. Ingrassia, IIi, M.d.s.c. | Internal Medicine | 5668 E State St, Suite B600, Rockford, IL 61108-2490 | 2006-08-18 |
| 1447363866 | John A. Butler, M.d.s.c. | Internal Medicine | 5668 E State St, Suite B600, Rockford, IL 61108-2490 | 2006-08-17 |
| 1437263662 | Theodore S. Ingrassia IIi | Internal Medicine | 535 Roxbury Rd, Suite B600, Rockford, IL 61107-5076 | 2006-08-17 |
| 1912010273 | Fredric C. Kullberg | Internal Medicine | 535 Roxbury Rd, Suite B600, Rockford, IL 61107-5076 | 2006-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720636202 | Pulmonary Associates Ltd | Internal Medicine | 71 W 156th St Ste 203, Harvey, IL 60426-4262 | 2019-08-28 |
| 1336516467 | Hesham A. Hassaballa, Md, Ltd | Internal Medicine | 109 Symonds Dr Unit 684, Hinsdale, IL 60522-7304 | 2015-08-24 |
| 1497141394 | Pulmonary and Critical Care Solutions, LLC | Internal Medicine | 6116 N 2200 East Rd, Downs, IL 61736-9459 | 2015-04-08 |
| 1558771220 | Christopher Charles Sutton | Internal Medicine | 3 Saint Elizabeth Blvd, O Fallon, IL 62269-1281 | 2014-05-05 |
| 1861835985 | Christie Ann Brillante | Internal Medicine | 1801 W. Taylor, Suite 3c, Chicago, IL 60612-4795 | 2013-04-08 |
| 1992050850 | Thomas Christopher Draghi | Internal Medicine | 155 Linden Ave, Oak Park, IL 60302-2610 | 2012-07-17 |
| 1144586041 | Robert T Zeck | Internal Medicine | 13141 Lake Mary Dr, Plainfield, IL 60585-2650 | 2012-04-04 |
| 1508160359 | Aziz Rahman Md Facp PC | Internal Medicine | 1050 Martin Luther King Dr, Ste 109, Centralia, IL 62801 | 2011-01-07 |
| 1811211774 | Vitalcare Medical Sc | Internal Medicine | 1146 S Waukegan Rd, Waukegan, IL 60085-6731 | 2010-03-22 |
| 1508095605 | Farhan Zaidi | Internal Medicine | 444 N Northwest Hwy Ste 206, Park Ridge, IL 60068 | 2009-07-09 |
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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.