NPIMap

Organization Active NPI

Swedishamerican Hospital

  • Obstetrics & Gynecology Physician
  • Rockford, IL
National Provider Identifier
1306280433
Registry record updated Jul 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
SWEDISHAMERICAN HOSPITAL
Practice address
1415 E State St
8TH Floor
Rockford, IL 61104
Phone
(779) 696-9120
NPI assigned
Apr 19, 2013
Last updated
Jul 12, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2018

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

Authorized official

Name
Don Daniels
Title
VP
Phone
(815) 966-2084

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

1415 E State St
8TH Floor
Rockford, IL 61104

Mailing address

PO Box 78866
Milwaukee, WI 53278-8866

Other names 1

  • SA State Street OB/Gyn Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031215000012 IL Part B Supplier - Clinic/Group Practice 5799698346 Receives reassigned benefits from 506 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Rockford, IL; Roscoe, IL; Belvidere, IL; Rochelle, IL; Freeport, IL; Davis Junction, IL; Byron, IL

National Provider Directory

National Provider Directory
Tax ID family
Northern Illinois Surgery44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

Locations

380 E Il Route 38
Rochelle, IL 61068
Phone (779) 696-9050

1340 Charles St
Ste 100
Rockford, IL 61104
Phone (779) 696-1900

1415 E State St
Fl 8
Rockford, IL 61104
Phone (779) 696-9120

3505 N Bell School Rd
Rockford, IL 61114
Phone (779) 696-0300

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1366329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531353600000",
    "number": "1306280433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78866",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532788866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 E STATE ST",
            "address_2": "8TH FLOOR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61104",
            "telephone_number": "779-696-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWEDISHAMERICAN HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-19",
        "last_updated": "2018-07-12",
        "status": "A",
        "authorized_official_last_name": "DANIELS",
        "authorized_official_first_name": "DON",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "815-966-2084"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SA State Street OB/Gyn",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "SA State Street OB/Gyn",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; 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.