Northern Illinois Nephrology, S.C

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

NORTHERN ILLINOIS NEPHROLOGY, S.C

Practice address

1340 Charles St Ste 400
Rockford, IL 61104-2200

Phone

(815) 398-9590

NPI assigned

Jul 18, 2006

Organization subpart

No

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

Authorized official

Name

David L Wright, MDNPI 1033131776

Title

President/Owner

Phone

(815) 398-9590

Specialties & licenses 1

Addresses

Locations

Practitioners 4

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

• David L Wright, MD

  • Nephrology Physician
  • Rockford, IL
  • NPI 1033131776
  NPD (past) Authorized official
• Mashood Ahmad, MD

  • Nephrology Physician
  • Rockford, IL
  • NPI 1043232846
  NPD (past)
• Joanna M Niemiec, MD

  • Nephrology Physician
  • Rockford, IL
  • NPI 1821016791
  NPD (past)
• Virginia A Evans, PA-C

  • Physician Assistant
  • Madison, WI
  • NPI 1639289770
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295753176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1340 CHARLES ST STE 400",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042200",
            "telephone_number": "815-398-9590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 CHARLES ST STE 400",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042200",
            "telephone_number": "815-398-9590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN ILLINOIS NEPHROLOGY, S.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "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": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "815-398-9590",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northern Illinois Behavioral Health Group
• Northern Illinois Hospice Association
• Northern Illinois Imaging
• Northern Illinois Medical Group S. C.
• Northern Illinois Nephrology
• Northern Illinois Optical Co., Inc.
• Northern Illinois Retina LTD
• Northern Illinois Scanning
• Northern Illinois Trauma Regional Orthopaedics, LLC
• Northern Illinois Vein Clinic, LLC

• Nephrology Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Nephrology Physician 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.