Active NPI
Irene Dyer, PA
- Physician Assistant
- Rockford, IL
National Provider Identifier
1437534666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085.002716
- Practice address
- 1560 Red Oak LN
Rockford, IL 61107-2767 - Phone
- (815) 540-3722
- NPI assigned
- Jul 29, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085.002716 | IL | Primary |
Addresses
Primary practice location
1560 Red Oak LN
Rockford, IL 61107-2767
Mailing address
1560 Red Oak LN
Rockford, IL 61107-2767
Phone (815) 540-3722
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085.002716 | IL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438128000000",
"number": "1437534666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1560 RED OAK LN",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611072767",
"telephone_number": "815-540-3722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1560 RED OAK LN",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611072767",
"telephone_number": "815-540-3722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DYER",
"first_name": "IRENE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-29",
"last_updated": "2015-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085.002716",
"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 Jul 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.