Active NPI
Matthew Kottackal George, M.D.
- Vascular Surgery Physician
- Rockford, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 036.166381
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 LLCVascular Surgery Associates PLLCOsf Multi-Specialty Group
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
- Amita Health Resurrection Medical Center
- Silver Cross Hospital and Medical Centers
- Saint Francis Hospital-Evanston
- Presence Saints Mary and Elizabeth Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Varicose vein removal | 1-10 |
| Leg revascularization (restoring blood flow) | 63 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036166381 | IL | MD | Surgical Critical Care Physician |
| 036.166381 | IL | MD | Vascular Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rockford Health Physicians | Current | Accepting new patients | |
| Prime Healthcare Illinois Medical Group LLC | Current | Accepting new patients | |
| Cardiothoracic & Vascular Surgical Associates S C | Vascular Surgery | Current | Accepting new patients |
| Vascular Surgery Associates, PLLC | Vascular Surgery | Current | 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.
-
- Multi-Specialty Clinic/Center
- Des Plaines, IL
- NPI 1023837689
IL
-
- Vascular Surgery Physician
- Chicago Ridge, IL
- NPI 1538791793
IL, Vascular Surgery
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Oak Lawn, IL
- NPI 1780679407
Vascular Surgery
-
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Oak Lawn, IL
- NPI 1548375082
Hospital
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1811735228
Hospital
-
- General Acute Care Hospital
- Evanston, IL
- NPI 1982442398
Hospital
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1265270607
Hospital
-
- Rehabilitation Hospital Unit
- New Lenox, IL
- NPI 1003933797
Hospital
-
- General Acute Care Hospital
- New Lenox, IL
- NPI 1568553519
Hospital
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.