NPIMap

Organization Active NPI

Northern Illinois Vein Clinic, LLC

  • Diagnostic Radiology Physician
  • Rockford, IL
National Provider Identifier
1407824022
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
NORTHERN ILLINOIS VEIN CLINIC, LLC
Practice address
1340 Charles St
Suite 404
Rockford, IL 61104-2200
Phone
(815) 316-8346
NPI assigned
Mar 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Authorized official

Name
Edward Steffen, MDNPI 1982658217
Title
MD
Phone
(815) 316-8346

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

1340 Charles St
Suite 404
Rockford, IL 61104-2200

Mailing address

PO Box 4632
Rockford, IL 61110-4632
Phone (815) 391-7285

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2990 N Perryville Rd
Unit 3400
Rockford, IL 61107
Phone (815) 316-8346

2127 Midlands Ct
Unit 102
Sycamore, IL 60178
Phone (815) 758-3057

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196812800000",
    "number": "1407824022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4632",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611104632",
            "telephone_number": "815-391-7285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 CHARLES ST",
            "address_2": "SUITE 404",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042200",
            "telephone_number": "815-316-8346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN ILLINOIS VEIN CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-09",
        "last_updated": "2007-12-05",
        "status": "A",
        "authorized_official_last_name": "STEFFEN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "815-316-8346",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 5, 2007; 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.