GREGORY BULLIS (NPI# 1497784797) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497784797 |
| Entity Type | Individual |
| Full Name | GREGORY BULLIS |
| Credential | M.D. |
| Practice Address |
5666 East State St Rockford IL 61108-2472 |
| Practice Telephone | 8152262000 |
| Practice Fax Number | 8153817582 |
| Mailing Telephone | 8152262000 |
| Mailing Fax Number | 8153817582 |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2013-11-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
036067306 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 36067306 | 05 |
| Street Address |
5666 EAST STATE ST |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61108-2472 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902833999 | Mete Korkmaz | Internal Medicine | 5666 East State St, Rockford, IL 61108-2472 | 2006-06-27 |
| 1831207174 | Pia Angela Ong | Hospitalist | 5666 East State St, Rockford, IL 61108-2472 | 2006-08-28 |
| 1780604900 | Anil J Amin | Hospitalist | 5666 East State St, Rockford, IL 61108-2472 | 2006-07-20 |
| 1427080811 | Lenore C Conboy | Dietitian, Registered | 5666 East State St, Rockford, IL 61108-2472 | 2006-07-07 |
| 1740212638 | Julie A De Roush | Dietitian, Registered | 5666 East State St, Rockford, IL 61108-2472 | 2006-07-07 |
| 1639100324 | Priscilla M Babler | Dietitian, Registered | 5666 East State St, Rockford, IL 61108-2472 | 2006-07-05 |
| 1760411367 | Allan Ong | Hospitalist | 5666 East State St, Rockford, IL 61108-2472 | 2006-07-03 |
| 1124058599 | Charles D Washington | Emergency Medicine | 5666 East State St, Rockford, IL 61108-2472 | 2006-07-03 |
| 1871523258 | George Gorchynsky | Emergency Medicine | 5666 East State St, Rockford, IL 61108-2472 | 2006-07-03 |
| 1376570846 | Richard Nora | Internal Medicine | 5666 East State St, Rockford, IL 61108-2472 | 2006-06-28 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 61108 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396879268 | Nanci A Cherry | Emergency Medicine | 7419 Bell Harbour Dr, Rockford, IL 61114-6600 | 2007-03-15 |
| 1770781148 | Jason D Riesinger | Emergency Medicine | 2400 N Rockton Ave, Rockford Health Physicians, Rockford, IL 61103-3655 | 2007-07-06 |
| 1215029582 | Jean M. Kriz | Emergency Medicine | 5666 E State St, Rockford, IL 61108-2425 | 2006-09-28 |
| 1124058599 | Charles D Washington | Emergency Medicine | 5666 East State St, Rockford, IL 61108-2472 | 2006-07-03 |
| 1871523258 | George Gorchynsky | Emergency Medicine | 5666 East State St, Rockford, IL 61108-2472 | 2006-07-03 |
| 1992734297 | Robin F Borchardt | Emergency Medicine | 5875 E Riverside Blvd, Rockford, IL 61114 | 2006-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033760715 | Michael James Doolin | Emergency Medicine | 1338 S Clinton St, Chicago, IL 60607-5037 | 2019-09-24 |
| 1578091971 | The Board of Trustee for The University of Illinois | Emergency Medicine | 10000 West O'hare, Terminal 2, Chicago, IL 60660-0508 | 2017-05-30 |
| 1669712808 | Kathryn Theresa Pajak | Emergency Medicine | 5659 S Oak Park Ave, Chicago, IL 60638-3227 | 2013-02-26 |
| 1174832976 | Craig William Dean | Emergency Medicine | 155 N Harbor Dr Apt 309, Chicago, IL 60601-7386 | 2010-09-28 |
| 1770809881 | King, Ltd | Emergency Medicine | 9332 S Vanderpoel Ave, Chicago, IL 60643-5852 | 2010-04-14 |
| 1306098231 | Robert Dietz Tetik | Emergency Medicine | 2272 95th St Ste 106, Naperville, IL 60564-8942 | 2008-10-22 |
| 1831384643 | Primus Trauma Care LLC | Emergency Medicine | 1304 Franklin Avenue, Normal, IL 61761 | 2007-09-14 |
| 1245355411 | Pekin Memorial Hospital | Emergency Medicine | 600 So 13th Street, Pekin, IL 61554-4969 | 2007-03-20 |
| 1972609782 | Jennifer Lynn Webb | Emergency Medicine | 15730 Robert Louis Dr, Plainfield, IL 60544-2146 | 2006-09-16 |
| 1073629374 | Stuart Hickerson | Emergency Medicine | 12528 Sr 78, Havana, IL 62644-6866 | 2006-08-21 |
| 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.