DR. AZHAR KOTHAWALA (NPI# 1891042552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891042552 |
| Entity Type | Individual |
| Full Name | DR. AZHAR KOTHAWALA |
| Credential | M.D. |
| Practice Address |
1235 N Mulford Rd Ste 222 Rockford IL 61107-3879 |
| Mailing Address |
2202 Harlem Road Suite 200 Loves Park IL 61111-2754 |
| Practice Telephone | 8153978400 |
| Practice Fax Number | 8152290050 |
| Mailing Telephone | 8158774848 |
| Mailing Fax Number | 8156366125 |
| Enumeration Date | 2012-08-12 |
| Last Update Date | 2018-07-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | 036.140452 | IL | Allopathic & Osteopathic Physicians |
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
036.140452 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036140452 | 05 |
| Street Address |
1235 N MULFORD RD STE 222 |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61107-3879 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104859107 | William Stephen Minore | Anesthesiology | 1235 N Mulford Rd Ste 222, Rockford, IL 61107-3879 | 2006-07-10 |
| 1003442880 | Candice Vicencio | Nurse Practitioner | 1235 N Mulford Rd Ste 222, Rockford, IL 61107-3879 | 2020-03-12 |
| 1407309982 | Daniel Robert Green | Registered Nurse | 1235 N Mulford Rd Ste 222, Rockford, IL 61107-3879 | 2016-08-01 |
| 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 | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| 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 Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336306406 | Ishmeet Singh | Anesthesiology | 2400 N Rockton Avenue, Rockford Health Physicians, Rockford, IL 61103-3619 | 2008-05-16 |
| 1528068699 | Hany M Afram | Anesthesiology | 6067 Strathmoor Dr, Rockford, IL 61107-6631 | 2005-07-29 |
| 1447542501 | James M G Sturm Do Daba | Anesthesiology | 6957 Olde Creek Rd, Rockford, IL 61114-7423 | 2011-05-09 |
| 1689991713 | Rockford Pain Center Ltd | Anesthesiology | 2902 Mcfarland Rd, # 202, Rockford, IL 61107-6801 | 2010-04-29 |
| 1316107097 | Pain-free Living Services of Illinois, S.c. | Anesthesiology | 6785 Weaver Rd, Ste D, Rockford, IL 61114-8055 | 2008-06-16 |
| 1801842935 | Pain Management Associates, Ltd | Anesthesiology | 6067 Strathmoor Dr, Rockford, IL 61107-6631 | 2006-05-26 |
| 1497704720 | Arkadiusz Grochowski | Anesthesiology | 5301 E State St, Ste. 101, Rockford, IL 61108-2901 | 2006-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538775770 | Regenerative Pain & Spine LLC | Anesthesiology | 2122 W Devon Ave, Chicago, IL 60659-3581 | 2020-09-22 |
| 1215552880 | Babu Prasad, Md | Anesthesiology | 2035 W Iles Ave Ste A, Springfield, IL 62704-7000 | 2020-06-10 |
| 1093330516 | Modern Pain Consultants | Anesthesiology | 1802 N Division St Ste 605, Morris, IL 60450-3133 | 2020-06-10 |
| 1255956777 | Modern Pain Consultants | Anesthesiology | 1890 Silver Cross Blvd Ste 315, New Lenox, IL 60451-9605 | 2020-06-10 |
| 1144844036 | Interventional Pain Medicine of Chicago Sc | Anesthesiology | 4433 W Touhy Ave Ste 235, Lincolnwood, IL 60712-1830 | 2020-06-05 |
| 1720627862 | Mm Infusions LLC | Anesthesiology | 1605 S Michigan Ave Unit 1, Chicago, IL 60616-1209 | 2020-01-06 |
| 1538719778 | Cpc Surgical Suite LLC | Anesthesiology | 555 W Court St Ste 100, Kankakee, IL 60901-3673 | 2019-09-19 |
| 1659854008 | Rich Noren LLC | Anesthesiology | 9000 Waukegan Rd Ste 12, Morton Grove, IL 60053-2127 | 2018-09-12 |
| 1003336470 | Vertex Anesthesia LLC | Anesthesiology | 10 Orland Square Dr # 10-c, Orland Park, IL 60462-3207 | 2017-06-26 |
| 1306386644 | Advanced Pain and Anesthesia Consultants,pc | Anesthesiology | 5215 N California Ave Ste F715, Chicago, IL 60625-7014 | 2017-03-06 |
| 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.