KBCLINIC (NPI# 1912146119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912146119 |
| Entity Type | Organization |
| Organization Name | KBCLINIC |
| Practice Address |
5666 East State Street Ambulatory Surgery Center/ Dr Blumofe Rockford IL 61108-2425 |
| Mailing Address |
6838 N Kilpatrick Ave Lincolnwood IL 60712-2437 |
| Practice Telephone | 8152272274 |
| Mailing Telephone | 8477639241 |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2009-02-11 |
| Authorized Official Name | DR. KARIN ANNIKA BLUMOFE (GENERAL SURGEON) |
| Authorized Official Telephone | 8152272274 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 036093795 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
5666 EAST STATE STREET AMBULATORY SURGERY CENTER/ DR BLUMOFE |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61108-2425 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043280811 | Christopher M. Nielsen | Emergency Medicine | 5666 East State Street, Rockford, IL 61108-2425 | 2006-01-25 |
| 1134442213 | Bryan P Tully | Internal Medicine | 5666 East State Street, Rockford, IL 61108-2425 | 2010-03-03 |
| 1972706604 | Shylendra B Sreenivasappa | Internal Medicine | 5666 East State Street, Rockford, IL 61108-2425 | 2007-06-08 |
| 1164641791 | Iftekhar Y Ahmad | Radiology | 5666 East State Street, Rockford, IL 61108-2425 | 2007-04-24 |
| 1154453454 | Timothy P Coggin | Emergency Medicine | 5666 East State Street, Rockford, IL 61108-2472 | 2007-03-12 |
| 1356414890 | Vikram Gunnala | Internal Medicine | 5666 East State Street, Rockford, IL 61108-2472 | 2006-11-15 |
| 1295805174 | Binoy Kamal | Hospitalist | 5666 East State Street, Rockford, IL 61108-2472 | 2006-11-08 |
| 1700804028 | Azra Ali | Hospitalist | 5666 East State Street, Rockford, IL 61108-2472 | 2006-07-17 |
| 1447287495 | George T Bryan Jr. | Radiology | 5666 East State Street, Rockford, IL 61108-2472 | 2006-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952862617 | Isr Enterprises, Inc. | Homemaker | 129 Phelps Ave, Bldg 10, Ste 1008, Rockford, IL 61108 | 2019-03-26 |
| 1003306465 | Adrienne Nicole Black | Behavior Technician | 519 Woodland Dr, Woodland Dr, Rockford, IL 61108 | 2018-05-11 |
| 1184085201 | Integrative Healing Center, LLC | Clinic/Center | 6019 Fincham Drive, Rockford, IL 61108 | 2016-03-17 |
| 1730547936 | Perryville Dentist PC | Dentist | 845 S Perryville Rd, Unit 119, Rockford, IL 61108 | 2016-02-02 |
| 1023489853 | Nicole Ping Ticknor | Counselor | 433 S. Phelps Ave., Suite 2, Rockford, IL 61108 | 2015-10-20 |
| 1275940348 | Northwest Home Care, Inc. | Home Health | 1437 S. Bell School Road, Suite 7, Rockford, IL 61108 | 2014-07-21 |
| 1487072922 | Alecia Greenlee | Psychiatry & Neurology | Rosecrance Community Mental Health, 3815 Harrison Avenue, Rockford, IL 61108 | 2014-04-02 |
| 1871925446 | Maria Laura Gustafson | Interpreter | 3208 Wesleyan Ave., Rockford, IL 61108 | 2013-08-06 |
| 1346582822 | Joseph Peevey | Pathology | 5666 E State Street, Department of Pathology, Rockford, IL 61108 | 2013-03-21 |
| 1134466923 | James Henry Peck | Hearing Instrument Specialist | 2424 Charles St, Rockford, IL 61108 | 2013-01-14 |
| Find all providers in zip 61108 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750584058 | Elisha Jamyce Robinson | Surgery | 2509 Mandrake Dr, Rockford, IL 61108-8132 | 2007-06-06 |
| 1871585034 | Frederick William Church | Surgery | 7180 Spring Brook Rd, Suite B, Rockford, IL 61114-6700 | 2005-08-15 |
| 1770846974 | Krystle N Lange | Surgery | 1340 Charles St Ste 100, Rockford, IL 61104-2200 | 2012-06-21 |
| 1881973014 | Igal Breitman | Surgery | 2300 N Rockton Ave, Rockford, IL 61103-3619 | 2011-08-05 |
| 1518253640 | Lacey M Stelle | Surgery | 1340 Charles St Ste 100, Rockford, IL 61104-2200 | 2011-06-27 |
| 1447550884 | Tetsuya Takeuchi | Surgery | 5668 E State St, Rockford, IL 61108-2464 | 2010-11-02 |
| 1558686709 | Michael Anthony Hart | Surgery | 5668 E State St, Rockford, IL 61108-2464 | 2010-03-31 |
| 1285965905 | John Eric Player | Surgery | 5668 E State St, Suite 1000, Rockford, IL 61108-2464 | 2010-01-20 |
| 1033384904 | William James Cowden | Surgery | 2300 N Rockton Ave, Suite 304, Rockford, IL 61103-3619 | 2008-04-23 |
| 1063686848 | Dacia Aurelia Pickering | Surgery | 5668 E State St, #2, Rockford, IL 61108-2490 | 2008-04-14 |
| Find all providers in ROCKFORD | ||||
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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.