Individual provider Active NPI

Angela M Rodriguez Tormes, MD

  • Pediatrics Physician
  • Rockford, IL
National Provider Identifier
1639289820
Registry record updated Feb 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036-069024 Issued in IL
Practice address
5970 Churchview Dr
Pediatrics
Rockford, IL 61107-2574
Phone
(815) 971-2000
Fax
(815) 971-9267
NPI assigned
Aug 30, 2006
Last updated
Feb 19, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036-069024 IL Primary

Addresses

Primary practice location

5970 Churchview Dr
Pediatrics
Rockford, IL 61107-2574

Mailing address

5970 Churchview Dr
Pediatrics
Rockford, IL 61107-2574
Phone (815) 971-2000

Other identifiers 1

IdentifierTypeStateIssuer
036069024MedicaidIL

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-069024ILMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424304000000",
    "number": "1639289820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5970 CHURCHVIEW DR",
            "address_2": "PEDIATRICS",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611072574",
            "telephone_number": "815-971-2000",
            "fax_number": "815-971-9267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5970 CHURCHVIEW DR",
            "address_2": "PEDIATRICS",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611072574",
            "telephone_number": "815-971-2000",
            "fax_number": "815-971-9267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ TORMES",
        "first_name": "ANGELA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-069024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036069024",
            "state": "IL"
        }
    ],
    "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 Feb 19, 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.

Verify at the official NPI Registry.