City of Rockford

Primary specialty

AmbulanceTaxonomy code 341600000X

License

011398 Issued in IL

Legal business name

CITY OF ROCKFORD

Practice address

204 S 1St St
Rockford, IL 61104-2033

Phone

(815) 987-5663

NPI assigned

Feb 2, 2006

Organization subpart

No

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

Authorized official

Name

Greg Castronovo

Title

Chief

Phone

(815) 987-5663

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Rockford Emergency Ambulance Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1720050826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8750",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601978750",
            "telephone_number": "937-424-3701",
            "fax_number": "937-291-2971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 S 1ST ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042033",
            "telephone_number": "815-987-5663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF ROCKFORD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-02",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CASTRONOVO",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "815-987-5663"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IL",
            "license": "011398",
            "primary": true
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "10115151",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590009290",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rockford Emergency Ambulance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Frederick William Church, M.D.
• Sierra Cichon, MS CCC-SLP
• Tubanur Ciftci
• Citadel at Saint Anne Place LLC
• Citied
• Clarity Counseling and Mediation Inc
• Irisha Gerrhea Clark, MD
• Jean K Clark, LCPC
• Jendaya M Clark
• Kyle R Clark, PA-C

• Ambulance in Rockford, IL
• Providers in Rockford, IL by specialty
• Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.