NORTHERN ILLINOIS TRAUMA REGIONAL ORTHOPAEDICS, LLC (NPI# 1578971487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578971487 |
| Entity Type | Organization |
| Organization Name | NORTHERN ILLINOIS TRAUMA REGIONAL ORTHOPAEDICS, LLC |
| Practice Address |
1235 N Mulford Rd Suite 103 Rockford IL 61107-3879 |
| Practice Telephone | 8156360700 |
| Practice Fax Number | 8159046033 |
| Mailing Telephone | 8156360700 |
| Mailing Fax Number | 8159046033 |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2017-03-27 |
| Authorized Official Name | ANDREW J BLINT (OWNER) |
| Authorized Official Telephone | 8156360700 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0801X |
Orthopaedic Surgery Specialization: Orthopaedic Trauma |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | F100170041 | 05 |
| Street Address |
1235 N MULFORD RD SUITE 103 |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61107-3879 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821091075 | Susan M Fowell | Ophthalmology | 1235 N Mulford Rd, Suite 100, Rockford, IL 61107-3879 | 2005-05-23 |
| 1164875852 | Bryn Maxine Byers Krause | Nurse Practitioner | 1235 N Mulford Rd, Suite 205, Rockford, IL 61107-3879 | 2016-07-18 |
| 1306211198 | Christine Lenox | Counselor | 1235 N Mulford Rd, Suite 200, Rockford, IL 61107-3879 | 2015-12-06 |
| 1962873919 | Renviva LLC | Clinic/Center | 1235 N Mulford Rd, Rockford, IL 61107-3879 | 2015-10-16 |
| 1598053571 | Stephanie Jo Drake | Physical Therapy Assistant | 1235 N Mulford Rd, Rockford, IL 61107-3879 | 2011-07-12 |
| 1932437290 | Surgical Services of Illinois, Sc | Dermatology | 1235 N Mulford Rd, Ste. 205, Rockford, IL 61107-3879 | 2009-11-25 |
| 1154576221 | Tanya J. Munger | Registered Nurse | 1235 N Mulford Rd, Suite 222, Rockford, IL 61107-3879 | 2008-11-17 |
| 1376714600 | Laura Koch | Clinical Nurse Specialist | 1235 N Mulford Rd, Suite 200, Rockford, IL 61107-3879 | 2008-03-14 |
| 1669640504 | Todd D Alexander Md Sc | Neurological Surgery | 1235 N Mulford Rd, Suite 210, Rockford, IL 61107-3879 | 2008-02-13 |
| 1942483664 | Northern Illinois Retina Ltd | Ophthalmology | 1235 N Mulford Rd, Suite 100, Rockford, IL 61107-3879 | 2007-12-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356952139 | Jessica Marie Tamayo Fernandez | Pharmacist | 1145 Alpine Rd, Rockford, IL 61107 | 2020-08-13 |
| 1467092379 | Unknown Safa Fatima | Student in an Organized Health Care Education/Training Program | Mercyhealth Mulford Clinic, 5970 Churchview Drive, Rockford, IL 61107 | 2020-01-08 |
| 1194367912 | Matt J Kriebs | Nurse Practitioner | 1235 N Mulford Rd Suite 103, Rockford, IL 61107 | 2019-10-14 |
| 1265962336 | Mary Golembeck | Nurse Practitioner | 7290 Argus Dr, Rockford, IL 61107 | 2017-06-12 |
| 1831644749 | Tessa Lee | Occupational Therapist | 3422 Lauderdale Ln, Rockford, IL 61107 | 2016-08-20 |
| 1942626965 | Elevated Health Essentials, LLC | Chiropractor | 124 N Water St Ste 204e, Rockford, IL 61107 | 2014-03-14 |
| 1093139909 | Swedishamerican Hospital | Surgery | 1639 N Alpine Rd Ste 400, Rockford, IL 61107 | 2014-02-12 |
| 1346676582 | Christopher Anthony Ziganto | Pharmacist | 494 Bienterra Trail #2, Rockford, IL 61107 | 2013-09-19 |
| 1023358272 | Lavanya Durairajan | Physical Therapist | 7358 Shiligton Dr, Rockford, IL 61107 | 2013-02-26 |
| 1851523146 | Great Smiles of Rockford | Durable Medical Equipment & Medical Supplies | 780 N. Mulfrord Road, Rockford, IL 61107 | 2009-08-20 |
| Find all providers in zip 61107 | ||||
| Taxonomy Code | 207XX0801X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Trauma |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic trauma surgeons deal with the evaluation and management of acute orthopaedic injuries, evaluation and treatment of post-traumatic deformities and nonunions, acute and delayed reconstruction of pelvic and acetabular fractures, as well as osteotomy in the adult hip for treatment of hip arthritis. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467645390 | Michal Pawel Zlowodzki | Orthopaedic Surgery | 2350 N Rockton Ave Fl 5, Rockford, IL 61103-3600 | 2007-08-23 |
| 1255314217 | Forrest Riordan | Orthopaedic Surgery | 1200 W State St, Rockford, IL 61102-2112 | 2005-11-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144721077 | Alana Eatinger | Orthopaedic Surgery | 5841 S Maryland Ave, Chicago, IL 60637-1443 | 2018-02-26 |
| 1629496609 | Rick Wang | Orthopaedic Surgery | 1740 W Taylor St, Chicago, IL 60612-7232 | 2014-04-07 |
| 1073872248 | Garin Gil Hecht | Orthopaedic Surgery | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2012-05-09 |
| 1629245717 | Richard A Geline M.d.s.c | Orthopaedic Surgery | 1225 Central Rd, Glenview, IL 60025-4349 | 2008-05-08 |
| 1912123134 | Matthew Paul Gardner | Orthopaedic Surgery | 800 N 1st St, Springfield, IL 62702-3719 | 2007-04-17 |
| 1639294952 | Steven Arthur Chandler | Orthopaedic Surgery | 9618 Southwest Highway, Oak Lawn, IL 60453-2862 | 2007-03-20 |
| 1528128089 | James Kapotas | Orthopaedic Surgery | 1901 W Harrison St, Chicago, IL 60612-3714 | 2006-12-12 |
| 1548357668 | Erika Mitchell | Orthopaedic Surgery | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2006-10-09 |
| 1861475964 | Gregory J Fahrenbach | Orthopaedic Surgery | 7447 W Talcott Ave, Suite 500 Northwest Orthopaedic Associates Ltd, Chicago, IL 60631-3745 | 2005-11-22 |
| 1467452318 | Mary K Morrell | Orthopaedic Surgery | 901 Biesterfield Rd, Suite 300, Elk Grove Village, IL 60007-3392 | 2005-07-21 |
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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.