Individual provider Active NPI

Matthew Kottackal George, M.D.

  • Vascular Surgery Physician
  • Rockford, IL
National Provider Identifier
1821484601
Registry record updated Feb 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
036.166381 Issued in IL
Practice address
5666 E State St
Rockford, IL 61108-2425
Phone
(815) 226-2000
NPI assigned
Apr 8, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X 036166381 IL
Vascular Surgery Physician 2086S0129X 036.166381 IL Primary

Addresses

Primary practice location

5666 E State St
Rockford, IL 61108-2425

Mailing address

6421 Burberry Dr
Rockford, IL 61114-7807
Phone (518) 391-0548

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
I20230825002566 IL Practitioner - Vascular Surgery 4688945660 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prime Healthcare Illinois Medical Group LLC 278 clinicians
Vascular Surgery Associates PLLC 7 clinicians
Osf Multi-Specialty Group 2,123 clinicians

Practice addresses (Care Compare)

100 N River Rd
Des Plaines, IL 60016-1209
Phone (847) 297-1800

10258 Southwest Hwy
Suite a
Chicago Ridge, IL 60415-1361
Phone (708) 346-9533

355 Ridge Ave
Evanston, IL 60202-3328
Phone (847) 316-4000

5666 E State St
Rockford, IL 61108-2425
Phone (815) 921-8929

7435 W Talcott Ave
Chicago, IL 60631-3707
Phone (773) 774-8000

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

  • Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208
  • Amita Health Resurrection Medical Center Hospital, Chicago, IL, CCN 140117
  • Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213
  • Saint Francis Hospital-Evanston Hospital, Evanston, IL, CCN 140080
  • Presence Saints Mary and Elizabeth Medical Center Hospital, Chicago, IL, CCN 140180

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)63
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036166381ILMDSurgical Critical Care Physician
036.166381ILMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Health Physicians CurrentSince Jan 13, 2026 Accepting new patients
Prime Healthcare Illinois Medical Group LLC CurrentSince Jan 3, 2026 Accepting new patients
Cardiothoracic & Vascular Surgical Associates S C Vascular Surgery CurrentSince Nov 15, 2024 Accepting new patients
Vascular Surgery Associates, PLLC Vascular Surgery CurrentSince Nov 15, 2024 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

1801 W Olympic Blvd
#2636
Pasadena, CA 91199

1325 N Highland Ave
Aurora, IL 60506
Phone (630) 801-2756

100 Provena Way
Ste 103
Bourbonnais, IL 60914
Phone (815) 937-8780

Carol Stream, IL 60122

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

10258 Southwest Hwy
Ste A
Chicago Ridge, IL 60415
Phone (708) 346-9533

100 N River Rd
Des Plaines, IL 60016
Phone (847) 297-1800

201 N Hammes Ave
Joliet, IL 60435
Phone (224) 273-6350

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

8201 E Riverside Blvd
Rockford, IL 61114
Phone (815) 971-4066

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

Organizations & group practices 6

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 7

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": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770336000000",
    "number": "1821484601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6421 BURBERRY DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611147807",
            "telephone_number": "518-391-0548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5666 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082425",
            "telephone_number": "815-226-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "MATTHEW",
        "middle_name": "KOTTACKAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-08",
        "last_updated": "2026-02-06",
        "certification_date": "2026-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "IL",
            "license": "036166381",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": "036.166381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.