SWEDISHAMERICAN HOSPITAL (NPI# 1619029881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619029881 |
| Entity Type | Organization |
| Organization Name | SWEDISHAMERICAN HOSPITAL |
| Other Organization Name | SA MIDTOWN CLINIC |
| Practice Address |
1340 Charles St Suite 405 Rockford IL 61104 |
| Mailing Address |
Po Box 78866 Milwaukee WI 53278-8866 |
| Practice Telephone | 7796965353 |
| Enumeration Date | 2007-01-17 |
| 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 | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | CLIA | 14D0430105 | 01 |
| Other Name | Type Code |
|---|---|
| SA Midtown 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 |
1340 CHARLES ST SUITE 405 |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063418143 | Kathleen Edna Williams | Nurse Practitioner | 1340 Charles St, Ste 201, Rockford, IL 61104 | 2005-06-23 |
| 1124526652 | Drew W Pearson | Registered Nurse | 1340 Charles St, Rockford, IL 61104-2200 | 2018-01-30 |
| 1417483322 | Andrea K Mehlbaum | Registered Nurse | 1340 Charles St, Suite 200, Rockford, IL 61104-2200 | 2017-05-11 |
| 1770030801 | Mary L Marshall | Registered Nurse | 1340 Charles St, Suite 300, Rockford, IL 61104-2200 | 2016-09-07 |
| 1518318047 | Laura G Padron | Registered Nurse | 1340 Charles St, Suite 300, Rockford, IL 61104 | 2016-06-27 |
| 1689056285 | Mary E Novotny | Registered Nurse | 1340 Charles St, Suite 100, Rockford, IL 61104 | 2015-06-19 |
| 1356759294 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St, Suite 300, Rockford, IL 61104 | 2014-07-23 |
| 1104237130 | John Russell | Registered Nurse | 1340 Charles St, Suite 300, Rockford, IL 61104 | 2014-05-13 |
| 1760824114 | Kaitlin L Georgiafandis | Physician Assistant | 1340 Charles St, Rockford, IL 61104-2200 | 2013-07-26 |
| 1326486895 | Daniel Clark Painter | Physical Medicine & Rehabilitation | 1340 Charles St, Suite 100, Rockford, IL 61104-2200 | 2013-06-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699216564 | Swedishamerican Hospital | Nutritionist | 1415 E. State St., Lower Level A3, Rockford, IL 61104 | 2017-03-13 |
| 1376950485 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 200, Rockford, IL 61104 | 2014-07-21 |
| 1871907774 | Oday Alsarraf | Psychiatry & Neurology | 1401 E State Street, Center for Mental Health, Swedish American Hospital, Rockford, IL 61104 | 2014-06-18 |
| 1962652339 | Children's Home and Aid | Community/Behavioral Health | 424 7th St, Rockford, IL 61104 | 2008-09-23 |
| 1689729535 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 100, Rockford, IL 61104 | 2007-01-23 |
| 1790873016 | David J Schleicher | Obstetrics & Gynecology | 209 9th St Ste 200, Rockford, IL 61104 | 2006-10-11 |
| 1013026624 | Thomas Ryan Moss | Dentist | 1415 E State Street, Rockford, IL 61104 | 2006-08-29 |
| 1366452096 | Arturo Santiago Manas | Obstetrics & Gynecology | 1415 E State St Fl 8, Rockford, IL 61104 | 2006-08-08 |
| 1245263268 | William John Stout | Physician Assistant | 1401 E State Street, Rockford, IL 61104 | 2006-07-10 |
| 1689604969 | Prabha Chand Dosi | Pediatrics | 1401 E. State Street, Rockford, IL 61104 | 2006-07-03 |
| Find all providers in zip 61104 | ||||
| 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 |
|---|---|---|---|---|
| 1851910350 | Charity L Soles | Family Medicine | 4134 Ashwinton Way, Rockford, IL 61109-3273 | 2020-04-14 |
| 1306250543 | Camille Ryan | Family Medicine | 6050 Northland Dr Ne Ste 200, Rockford, MI 49341-9257 | 2014-06-16 |
| 1396991485 | Novella Ann Schafer | Family Medicine | 3719 Regal Ridge Circle, Rockford, IL 61114-6037 | 2008-08-08 |
| 1417139130 | Derek Lanier | Family Medicine | 8450 Brower Lake Rd Ne, Apt/suite, Rockford, MI 49341-9346 | 2007-12-04 |
| 1144414921 | Moses Godofredo Tomacruz | Family Medicine | 1502 Parkview Ave, Rockford, IL 61107-1821 | 2007-09-05 |
| 1508077165 | Robert Dejonge Do PC | Family Medicine | 350 Northland Dr Ne, Rockford, MI 49341-1401 | 2007-05-25 |
| 1902018641 | Julie Stark | Family Medicine | 3475 So Alpine Rd, Physicians Immediate Care, Rockford, IL 61109-2604 | 2007-05-04 |
| 1205976024 | Mohammed Khaleeluddin | Family Medicine | 1729 Oak Park Drive, Rockford, IL 61107-5510 | 2007-02-08 |
| 1134273238 | Swedishamerican Hosptial | Family Medicine | 3906 N Main St, Suite A, Rockford, IL 61103-1679 | 2007-01-23 |
| 1194897223 | Niccole Ranz | Family Medicine | 2222 E State St, Suite 209, Rockford, IL 61104-1573 | 2006-11-14 |
| Find all providers in ROCKFORD | ||||
Please comment or provide details below to improve the information on SWEDISHAMERICAN HOSPITAL.
| 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.