Northern Illinois Nephrology

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

NORTHERN ILLINOIS NEPHROLOGY

Practice address

1340 Charles St
Suite 400
Rockford, IL 61104-2200

Phone

(815) 398-9590

Fax

(815) 398-9591

NPI assigned

Apr 23, 2007

Last updated

Aug 22, 2020By 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. David L Wright, M.D

Title

Ceo

Phone

(815) 398-9590

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205054533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 CHARLES ST",
            "address_2": "SUITE 400",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042200",
            "telephone_number": "815-398-9590",
            "fax_number": "815-398-9591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 CHARLES ST",
            "address_2": "SUITE 400",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042200",
            "telephone_number": "815-398-9590",
            "fax_number": "815-398-9591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN ILLINOIS NEPHROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "815-398-9590",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Main Nursing and Rehab Center
• Northern Illinois Behavioral Health Group
• Northern Illinois Hospice Association (Northern Illinois Hospice)
• Northern Illinois Imaging
• Northern Illinois Medical Group S. C.
• Northern Illinois Nephrology, S.C
• Northern Illinois Optical Co., Inc.
• Northern Illinois Retina LTD
• Northern Illinois Scanning
• Northern Illinois Trauma Regional Orthopaedics, LLC

• Specialist in Rockford, IL
• Providers in Rockford, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.