Frederick William Church, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036044472 Issued in IL

Practice address

7180 Spring Brook Rd
Suite B
Rockford, IL 61114-6700

Phone

(815) 971-2299

Fax

(815) 971-9749

NPI assigned

Aug 15, 2005

Last updated

Apr 12, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365724800000",
    "number": "1871585034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7180 SPRING BROOK RD",
            "address_2": "SUITE B",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611146700",
            "telephone_number": "815-971-2299",
            "fax_number": "815-971-9749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7180 SPRING BROOK RD",
            "address_2": "SUITE B",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611146700",
            "telephone_number": "815-971-2299",
            "fax_number": "815-971-9749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "FREDERICK",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2013-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036044472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beth A Christiansen, APN
• Christopher Greenwaldt, DMD, P.C.
• Corinne Chu, O.D.
• Thomas Tonghon Chung, D.D.S.
• Jeanne Marie Chupich, APN
• Sierra Cichon, MS CCC-SLP
• Tubanur Ciftci
• Citadel at Saint Anne Place LLC (Citadel at Saint Anne Place)
• Citied
• City of Rockford (Rockford Emergency Ambulance)

• Surgery Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; 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.