JENNIFER BOOMER


Address: 2400 N Rockton Ave, Rockford, IL 61103-3655
Phone: 8159715000

JENNIFER BOOMER (NPI# 1861901316) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1861901316
Entity Type Individual
Full Name JENNIFER BOOMER
Credential APN
Practice Address 2400 N Rockton Ave
Rockford
IL 61103-3655
Practice Telephone 8159715000
Enumeration Date 2017-09-28
Last Update Date 2017-09-28
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
209016612 IL Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 2400 N ROCKTON AVE
City ROCKFORD
State IL
Zip Code 61103-3655

Providers in the same location

NPI Name Taxonomy Address Enumeration
1457357592 Michael J Kikta Surgery 2400 N Rockton Ave, Rockford, IL 61103-3655 2005-06-23
1053950055 Tina Longphee Registered Nurse 2400 N Rockton Ave, Rockford, IL 61103-3655 2019-12-23
1598227407 Shahid Mohammad Student in an Organized Health Care Education/Training Program 2400 N Rockton Ave, Rockford, IL 61103-3655 2019-04-01
1265993109 Sarah Elaine Robertson Student in an Organized Health Care Education/Training Program 2400 N Rockton Ave, Rockford, IL 61103-3655 2019-03-25
1770042525 Vinita Patel Student in an Organized Health Care Education/Training Program 2400 N Rockton Ave, Rockford, IL 61103-3655 2019-03-19
1255890646 Gilda Djabarzade Student in an Organized Health Care Education/Training Program 2400 N Rockton Ave, Rockford, IL 61103-3655 2019-03-15
1285103002 Amy Lask Nurse Practitioner 2400 N Rockton Ave, Rockford, IL 61103-3655 2018-11-21
1477038743 Michelle Harris Advanced Practice Midwife 2400 N Rockton Ave, Rockford, IL 61103-3655 2018-10-02
1134603095 Sarah R Linder Nurse Practitioner 2400 N Rockton Ave, Rockford, IL 61103-3655 2018-09-17
1376022350 Atiq Urrehman Khan Psychiatry & Neurology 2400 N Rockton Ave, Rockford, IL 61103-3655 2018-08-09
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1598398497 The Elitist Group Home Health Aide 2929 N Main Street, Rockford, IL 61103 2020-02-19
1972064194 Mahita Bellamkonda Student in an Organized Health Care Education/Training Program 2400 North Rockton Avenue, Rockford, IL 61103 2019-03-29
1558538967 Willows Health Center Clinic/Center 4143 Albright Lane, Rockford, IL 61103 2008-05-14
1497845135 Humaira Bari Internal Medicine 2400 N. Rockton Avenue, Rockford, IL 61103 2006-10-13
1841385242 Rachel Pawlowski Occupational Therapist 3616 N. Main Street, Rockford, IL 61103 2006-10-03
1417068438 Alicia Anne Huntley Midwife 2400 Rockton Ave, Rockford, IL 61103 2006-08-31
1639190200 Glendon Burress Pediatrics 2300 N. Rockton Ave., Rockford Health Physicians, Rockford, IL 61103 2006-07-21
1225065204 Daniel William Johnson Dentist 519 Toner Av, Rockford, IL 61103 2006-06-27
1760472898 Ronald Peter Oberfoell Anesthesiology 2400 North Rockton Ave, Rockford Health Physicians, Rockford, IL 61103 2005-10-28
1841752532 Dipti Sabharwal Student in an Organized Health Care Education/Training Program 2400 N Rockton Avenue, Rockford, IL 61103 2019-04-02
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1174138481 Kelly Ann Twigg Nurse Practitioner 5669 Shelley Rd, Rockford, OH 45882-9577 2020-09-14
1699389882 Mary Ann Shaw Nurse Practitioner 207 W Main Ave, Rockford, IA 50468-1213 2020-09-04
1124632922 Catherine Nwosu Nurse Practitioner 3455 Holiday Dr Apt 10, Rockford, IL 61109-2489 2020-08-31
1790314631 Toni A Hughart Nurse Practitioner 6000 E State St, Rockford, IL 61108-2521 2020-04-03
1578199220 Keli S Griseta Nurse Practitioner 3505 N Bell School Rd, Rockford, IL 61114-6624 2020-03-13
1457986069 Nicole P Falatic Nurse Practitioner 153 Glen Eagle Dr Ne, Rockford, MI 49341-1183 2020-03-04
1194367912 Matt J Kriebs Nurse Practitioner 1235 N Mulford Rd Suite 103, Rockford, IL 61107 2019-10-14
1952869943 Angela Marie Hawkins Nurse Practitioner 8201 E. Riverside Blvd, Pediatric Neurology, Rockford, IL 61114 2019-03-08
1487110540 Karrie Hagger Nurse Practitioner 7476 Countryshire Ln, Rockford, IL 61107-2774 2019-02-13
1336652700 Stacey Jo Caler Nurse Practitioner 363 Financial Ct Unit 300, Rockford, IL 61107-6671 2017-11-08
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Competitor

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City ROCKFORD
Zip Code 61103

Improve Information

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Dataset Information

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.

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