Swedishamerican Hospital

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

Legal business name

SWEDISHAMERICAN HOSPITAL

Practice address

101 W 2ND St
Suite 130
Dixon, IL 61021-3076

Phone

(815) 288-0071

NPI assigned

May 21, 2008

Last updated

Feb 11, 2009By 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

Don Daniels

Title

VP

Phone

(815) 966-2084

Specialties & licenses 1

Addresses

Other names 1

• Town Square Centre Other name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 3

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.

• Suraj Bopanna, MD, MRCP

  • Pulmonary Disease Physician
  • Rockford, IL
  • NPI 1740433291
  NPD
• Michelle Fuller, APN

  • Nurse Practitioner
  • Rockford, IL
  • NPI 1982086237
  NPD
• David M Kushner, MD

  • Gynecologic Oncology Physician
  • Madison, WI
  • NPI 1659347672
  NPD

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234310400000",
    "number": "1336306935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1567",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611100067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 2ND ST",
            "address_2": "SUITE 130",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213076",
            "telephone_number": "815-288-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWEDISHAMERICAN HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-21",
        "last_updated": "2009-02-11",
        "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": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Town Square Centre",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Steven Svendsen, RBT
• Emma Swanson
• Kelsey Swanson
• Kyle Swanson
• Kayla Sward
• Mouhammad F Tarsha, M.D.
• Tyrone Tejam
• Courtney L Teller, PA-C
• Leigh Terrell, LCPC
• Terri Ann Thibado, MHP

• Hematology & Oncology Physician in Dixon, IL
• Providers in Dixon, IL by specialty
• Hematology & Oncology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2009; 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.