Rockford Rehabilitation Medicine, SC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

ROCKFORD REHABILITATION MEDICINE, SC

Practice address

2825 Glenwood Ave
Rockford, IL 61101-3542

Phone

(815) 965-9712

NPI assigned

Apr 27, 2006

Organization subpart

No

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

Authorized official

Name

Peter Park, MDNPI 1952359887

Title

MD

Phone

(815) 965-9712

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Peter K Park, MD

  • Physical Medicine & Rehabilitation Physician
  • Rockford, IL
  • NPI 1952359887
  NPD (past) Authorized official

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548227341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 GLENWOOD AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611013542",
            "telephone_number": "815-965-9712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 GLENWOOD AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611013542",
            "telephone_number": "815-965-9712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKFORD REHABILITATION MEDICINE, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "815-965-9712",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rockford Public Schools Dis205
• Rockford Pulmonary Clinic
• Rockford Radiation Oncology LTD
• Rockford Radiology Assoc
• Rockford Regional Specialty Lab
• Rockford Retina Clinic, S.C.
• Rockford RN First Assistant, PC
• Rockford School District
• Rockford SLF, LLC
• Rockford Spine Center, LTD

• Physical Medicine & Rehabilitation Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Physical Medicine & Rehabilitation Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.