Individual provider Active NPI

Xu Wang, M.D.

  • Cardiovascular Disease Physician
  • Rockford, IL
National Provider Identifier
1558577460
Registry record updated Sep 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
003602 Issued in GA
Practice address
444 Roxbury Rd
Rockford, IL 61107-5059
Phone
(815) 398-3000
NPI assigned
May 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 003602 GA Primary

Addresses

Primary practice location

444 Roxbury Rd
Rockford, IL 61107-5059

Mailing address

444 Roxbury Rd
Rockford, IL 61107-5059
Phone (815) 398-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120820000649 IL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7012058209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

444 Roxbury Rd
Rockford, IL 61107-5059
Phone (815) 398-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
003602GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jan 1, 2016 Accepting new patients
Hospital Authority of Wayne County Georgia Past Accepting new patients
Hospital Authority of Wayne County Georgia Past Accepting new patients

Locations

1 Kish Hospital Dr
DeKalb, IL 60115
Phone (815) 754-1521

1401 E 12th St
Mendota, IL 61342
Phone (815) 539-7461

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

900 N 2nd St
Rochelle, IL 61068
Phone (815) 562-2181

444 Roxbury Rd
#12471
Rockford, IL 61107

444 Roxbury Rd
Rockford, IL 61107
Phone (815) 395-9196

1850 Gateway Dr
Sycamore, IL 60178
Phone (815) 217-3252

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379635200000",
    "number": "1558577460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075059",
            "telephone_number": "815-398-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075059",
            "telephone_number": "815-398-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "XU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2013-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "003602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.