Beloit Clinic SC
Organization Active NPI Internal Medicine Physician · Roscoe, IL
NPI 1497879878 · NPPES record last updated Feb 6, 2008
Key facts
- NPI
- 1497879878
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- BELOIT CLINIC SC
- Practice address
- 5605 East Rockton Rd
North Pointe
Roscoe, IL 61073-7601 - Phone
- (815) 525-4500
- Fax
- (608) 364-2338
- NPI assigned
- Mar 19, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- BELOIT CLINIC SC
Authorized official
- Name
- William P Sullivan, CEO
- Title
- Administrator
- Phone
- (608) 364-2200
Corporate family (same tax ID) 3
National Provider Directory
- Tax ID family
- Beloit Circle SC
- Part of
- Beloit Circle SC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | WI | Yes |
Addresses
Primary practice location
5605 East Rockton Rd
North Pointe
Roscoe, IL 61073-7601
Mailing address
1905 Huebbe Parkway
Beloit Clinic SC
Beloit, WI 53511-1842
Phone (608) 364-2200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32808500 | Medicaid | WI | |
| 32270100 | Medicaid | WI | |
| 483240 | Other | ILLINOIS MEDICARE |
Other names
- Roscoe Clinic
Other providers in Roscoe, IL
- Jacquelyn A Baschleben
- Suzanne Bates
- BDD Eds PC
- Taylor Becker
- Bedazzled Salon and Spa
- Beloit Health System Inc
- Beloit Health System Inc
- Beloit Health System Inc
- Beloit Health System, Inc
- Marek S Bentkowski
All providers in Roscoe, IL · Internal Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 6, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.