Organization Active NPI

Surgical Associates of Northern Illinois

  • Surgery Physician
  • Rockford, IL
National Provider Identifier
1497736409
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SURGICAL ASSOCIATES OF NORTHERN ILLINOIS
Practice address
2350 N Rockton Ave
Suite 510
Rockford, IL 61103-3600
Phone
(815) 963-3426
Fax
(815) 963-3428
NPI assigned
Nov 8, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Authorized official

Name
Mary Ann Rauter
Title
Asst Office Manager
Phone
(815) 963-3426

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

2350 N Rockton Ave
Suite 510
Rockford, IL 61103-3600

Mailing address

2350 N Rockton Ave
Suite 510
Rockford, IL 61103-3600
Phone (815) 963-3426

National Provider Directory

National Provider Directory

Locations

2350 N Rockton Ave
Ste 510
Rockford, IL 61103
Phone (815) 963-3426

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1497736409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 N ROCKTON AVE",
            "address_2": "SUITE 510",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611033600",
            "telephone_number": "815-963-3426",
            "fax_number": "815-963-3428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 N ROCKTON AVE",
            "address_2": "SUITE 510",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611033600",
            "telephone_number": "815-963-3426",
            "fax_number": "815-963-3428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL ASSOCIATES OF NORTHERN ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-08",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "RAUTER",
        "authorized_official_first_name": "MARY ANN",
        "authorized_official_title_or_position": "ASST OFFICE MANAGER",
        "authorized_official_telephone_number": "815-963-3426"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "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 Jun 18, 2008; 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.