The Bridge Clinic of Rockofrd

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

Legal business name

THE BRIDGE CLINIC OF ROCKOFRD

Practice address

318 N Church St
Rockford, IL 61101-1006

Phone

(815) 494-1594

NPI assigned

Aug 27, 2015

Last updated

Aug 27, 2015By 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. Annette Olin, M.D.

Title

Medical Director

Phone

(815) 494-1594

Specialties & licenses 2

Addresses

Locations

Practitioners 2

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.

• Nicola Bennett, APNP

  • Nurse Practitioner
  • Burr Ridge, IL
  • NPI 1942655865
  NPD (past)
• Sara Anne Hormig, APN

  • Nurse Practitioner
  • Rockford, IL
  • NPI 1164826012
  NPD (past)

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440633600000",
    "number": "1154798916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16024",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611326024",
            "telephone_number": "815-494-1594",
            "fax_number": "866-506-0931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 N CHURCH ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611011006",
            "telephone_number": "815-494-1594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BRIDGE CLINIC OF ROCKOFRD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-27",
        "last_updated": "2015-08-27",
        "status": "A",
        "authorized_official_last_name": "OLIN",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "815-494-1594",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Arc of Winnebago, Boone and Ogle Counties
• The Attachment Group
• The Board of Trustees of the University of Illinois (UI Health Mile Square Health Center L. P. Johnson Rockford)
• The Board of Trustees of the University of Illinois (UI Health Mile Square Health Center L P Johnson Rockord)
• The Board of Trustees of the University of Illinois (Uic Merit)
• The Elitist Group
• The Fit Med Experience (Fit Med)
• The Inspiration and Life Enhancement
• The Lotus Center
• Tabitha Mae Theiler, RST, CST

• Voluntary or Charitable Agency in Rockford, IL
• Providers in Rockford, IL by specialty
• Voluntary or Charitable Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; 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.