SHYLENDRA B SREENIVASAPPA (NPI# 1972706604) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972706604 |
| Entity Type | Individual |
| Full Name | SHYLENDRA B SREENIVASAPPA |
| Credential | M.D. |
| Practice Address |
5666 East State Street Rockford IL 61108-2425 |
| Practice Telephone | 8152262000 |
| Mailing Telephone | 8152262000 |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2011-02-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 036-117669 | IL | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 36117669 | IL | Allopathic & Osteopathic Physicians |
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
036-117669 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036117669 | 05 |
| Street Address |
5666 EAST STATE STREET |
| 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 |
| 1912146119 | Kbclinic | Surgery | 5666 East State Street, Ambulatory Surgery Center/ Dr Blumofe, Rockford, IL 61108-2425 | 2009-02-11 |
| 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 | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861710857 | Swedishamerican Hospital | Internal Medicine | 2473 Mcfarland Rd, Rockford, IL 61107-6824 | 2010-05-14 |
| 1265625354 | Fauzia G Khattak | Internal Medicine | 3535 N Bell School Rd, Rockford, IL 61114 | 2007-08-22 |
| 1508942202 | Hosne Ara Begum | Internal Medicine | 2400 N Rockton Ave, Rockford Health Physicians, Rockford, IL 61103 | 2006-10-27 |
| 1821109448 | Nameer Mardini | Internal Medicine | 3535 N Bell School Rd, Rockford, IL 61114 | 2006-08-31 |
| 1558382069 | William Schulz | Internal Medicine | 3535 N Bell School Rd, Rockford, IL 61114 | 2006-07-21 |
| 1689695108 | Harvey Einhorn | Internal Medicine | 3535 N Bell School Rd, Rockford, IL 61114 | 2006-07-21 |
| 1427079938 | Sharon Shipp | Internal Medicine | 3535 N Bell School Rd, Rockford, IL 61114 | 2006-07-21 |
| 1992740963 | Merat Karbasian-esfahani | Internal Medicine | 3535 N Bell School Rd, Rockford, IL 61114 | 2006-06-16 |
| 1700837218 | Majed Abuhajir | Internal Medicine | 5666 E State St, Rockford, IL 61108-2472 | 2006-05-12 |
| 1437140258 | William Robert Edwards | Internal Medicine | 3535 N Bell School Rd, Rockford, IL 61114 | 2005-11-01 |
| 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.