Integrative Healing Center, LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

036.130252 Issued in IL

Legal business name

INTEGRATIVE HEALING CENTER, LLC

Practice address

6019 Fincham Drive
Rockford, IL 61108

Phone

(219) 902-7340

NPI assigned

Mar 17, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Elisha Robinson, M.D.NPI 1750584058

Title

Owner

Phone

(219) 902-7340

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elisha Jamyce Robinson, MD

  • Surgery Physician
  • Rockford, IL
  • NPI 1750584058

  IL

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1458172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458172800000",
    "number": "1184085201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2509 MANDRAKE DRIVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61108",
            "telephone_number": "219-902-7340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6019 FINCHAM DRIVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61108",
            "telephone_number": "219-902-7340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE HEALING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-17",
        "last_updated": "2016-03-17",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "ELISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-902-7340",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "IL",
            "license": "036.130252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Integrative Medical of Rockford
• Integrative Rehabilitation Center, SC
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• Nolan Jacob Interial, DO

• All providers in Rockford, IL
• Medical Specialty Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.