Active NPI
Beaute Emergente LLC
- Plastic Surgery Physician
- Rockford, IL
National Provider Identifier
1114047586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- 036111771
- Legal business name
- BEAUTE EMERGENTE LLC
- Practice address
- 3065 N Perryville Rd
Ste 141
Rockford, IL 61114-8053 - Phone
- (815) 397-3373
- NPI assigned
- Mar 30, 2007
- Last updated
- Jun 6, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- James S McAdoo, DO
- Title
- President
- Phone
- (815) 633-8586
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | 036111771 | IL | Primary |
Addresses
Primary practice location
3065 N Perryville Rd
Ste 141
Rockford, IL 61114-8053
Mailing address
6785 Weaver Rd
Ste D
Rockford, IL 61114-8055
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036111771 | Medicaid | IL |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Plastic Surgery Physician
- Rockford, IL
- NPI 1740260637
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175212800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1370476800000",
"number": "1114047586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6785 WEAVER RD",
"address_2": "STE D",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611148055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3065 N PERRYVILLE RD",
"address_2": "STE 141",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611148053",
"telephone_number": "815-397-3373"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BEAUTE EMERGENTE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-30",
"last_updated": "2013-06-06",
"status": "A",
"authorized_official_last_name": "MCADOO",
"authorized_official_first_name": "JAMES",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "815-633-8586",
"authorized_official_credential": "DO"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Plastic Surgery",
"state": "IL",
"license": "036111771",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036111771",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.