Perryville Surgical Associates SC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

PERRYVILLE SURGICAL ASSOCIATES SC

Practice address

535 Roxbury Rd
Rockford, IL 61107-5076

Phone

(815) 398-0175

Fax

(815) 398-9587

NPI assigned

Sep 15, 2006

Last updated

May 18, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kenneth W Mihelich, MDNPI 1649374737

Title

Secretary

Phone

(815) 398-0175

Specialties & licenses 1

Addresses

Other names 1

• Michael John Beierle MDSC Former legal business name

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.

• Kenneth W Mihelich, MD

  • Surgery Physician
  • Rockford, IL
  • NPI 1649374737
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305676800000",
    "number": "1154427664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075076",
            "telephone_number": "815-398-0175",
            "fax_number": "815-398-9587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075076",
            "telephone_number": "815-398-0175",
            "fax_number": "815-398-9587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRYVILLE SURGICAL ASSOCIATES SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2011-05-18",
        "status": "A",
        "authorized_official_last_name": "MIHELICH",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "815-398-0175",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michael John Beierle MDSC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Matteo Perrone, MD
• Perry K. Tuneberg D.D.S. and Associates
• Cecily Devon Perry
• Perryville Counseling Group PLLC
• Perryville Dentist PC
• Julia R Pesavento, D.M.D.
• Petalber Therapy Services
• Catharin Peters, APRN
• Chloe Peters
• Kelly Anne Peters, DPT

• Surgery Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.