FREDRIC C. KULLBERG (NPI# 1912010273) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912010273 |
| Entity Type | Individual |
| Full Name | FREDRIC C. KULLBERG |
| Credential | M.D. |
| Practice Address |
535 Roxbury Rd Suite B600 Rockford IL 61107-5076 |
| Practice Telephone | 8153977212 |
| Practice Fax Number | 8153972539 |
| Mailing Telephone | 8153977212 |
| Mailing Fax Number | 8153972539 |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2016-05-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
036 062004 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD | 101 00574 | 01 |
| IL | RAILROAD MEDICARE | 290000247 | 01 |
| IL | 036 062004 | 05 |
| Street Address |
535 ROXBURY RD SUITE B600 |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61107-5076 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750344404 | John C Collins | Psychiatry & Neurology | 535 Roxbury Rd, Rockford, IL 61107-5076 | 2006-04-11 |
| 1154881142 | Ashley Seyfert | Clinical Nurse Specialist | 535 Roxbury Rd, Rockford, IL 61107-5076 | 2019-03-25 |
| 1245702026 | Roshni Pradip Desai | Physician Assistant | 535 Roxbury Rd, Rockford, IL 61107-5076 | 2018-12-18 |
| 1083180228 | Andrea M Shewalter | Nurse Practitioner | 535 Roxbury Rd, Rockford, IL 61107-5076 | 2018-10-15 |
| 1740709336 | Christie Jo Gesin | Nurse Practitioner | 535 Roxbury Rd, Rockford, IL 61107-5076 | 2017-09-14 |
| 1871860056 | Saint Anthony Medical Center | Neurological Surgery | 535 Roxbury Rd, Rockford, IL 61107-5076 | 2011-11-16 |
| 1811277692 | Cpo Services, Inc | Prosthetic/Orthotic Supplier | 535 Roxbury Rd, Lower Level, Rockford, IL 61107 | 2011-08-24 |
| 1457540379 | Michelle Marie Sandine | Nurse Practitioner | 535 Roxbury Rd, Rockford, IL 61107-5076 | 2007-10-16 |
| 1245300284 | Meredydd Jane Harper | Nurse Practitioner | 535 Roxbury Rd, Rockford, IL 61107-5076 | 2006-11-08 |
| 1154427664 | Perryville Surgical Associates Sc | Surgery | 535 Roxbury Rd, Rockford, IL 61107-5076 | 2006-09-15 |
| 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 | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366552556 | Bharati P. Roy | Internal Medicine | 2300 N Rockton Ave, Rockford, IL 61103-3619 | 2006-08-30 |
| 1972617181 | Nadeem Hanif | Internal Medicine | 535 Roxbury Rd, Suite B600, Rockford, IL 61107-5076 | 2006-08-18 |
| 1780798801 | Nadeem Hanif, M.d.s.c. | Internal Medicine | 5668 E State St, Suite B600, Rockford, IL 61108-2490 | 2006-08-18 |
| 1568576734 | Theodore S. Ingrassia, IIi, M.d.s.c. | Internal Medicine | 5668 E State St, Suite B600, Rockford, IL 61108-2490 | 2006-08-18 |
| 1447364740 | Fredric C. Kullberg, M.d.s.c. | Internal Medicine | 5668 E State St, Suite B600, Rockford, IL 61108-2490 | 2006-08-17 |
| 1447363866 | John A. Butler, M.d.s.c. | Internal Medicine | 5668 E State St, Suite B600, Rockford, IL 61108-2490 | 2006-08-17 |
| 1437263662 | Theodore S. Ingrassia IIi | Internal Medicine | 535 Roxbury Rd, Suite B600, Rockford, IL 61107-5076 | 2006-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720636202 | Pulmonary Associates Ltd | Internal Medicine | 71 W 156th St Ste 203, Harvey, IL 60426-4262 | 2019-08-28 |
| 1336516467 | Hesham A. Hassaballa, Md, Ltd | Internal Medicine | 109 Symonds Dr Unit 684, Hinsdale, IL 60522-7304 | 2015-08-24 |
| 1497141394 | Pulmonary and Critical Care Solutions, LLC | Internal Medicine | 6116 N 2200 East Rd, Downs, IL 61736-9459 | 2015-04-08 |
| 1558771220 | Christopher Charles Sutton | Internal Medicine | 3 Saint Elizabeth Blvd, O Fallon, IL 62269-1281 | 2014-05-05 |
| 1861835985 | Christie Ann Brillante | Internal Medicine | 1801 W. Taylor, Suite 3c, Chicago, IL 60612-4795 | 2013-04-08 |
| 1992050850 | Thomas Christopher Draghi | Internal Medicine | 155 Linden Ave, Oak Park, IL 60302-2610 | 2012-07-17 |
| 1144586041 | Robert T Zeck | Internal Medicine | 13141 Lake Mary Dr, Plainfield, IL 60585-2650 | 2012-04-04 |
| 1508160359 | Aziz Rahman Md Facp PC | Internal Medicine | 1050 Martin Luther King Dr, Ste 109, Centralia, IL 62801 | 2011-01-07 |
| 1811211774 | Vitalcare Medical Sc | Internal Medicine | 1146 S Waukegan Rd, Waukegan, IL 60085-6731 | 2010-03-22 |
| 1508095605 | Farhan Zaidi | Internal Medicine | 444 N Northwest Hwy Ste 206, Park Ridge, IL 60068 | 2009-07-09 |
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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.