Rockford Pediatric Pulmonology, LTD.

Primary specialty

Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X

Legal business name

ROCKFORD PEDIATRIC PULMONOLOGY, LTD.

Practice address

7144 Kleckner Rd
Rockford, IL 61107-6821

Phone

(815) 636-7111

Fax

(815) 639-3526

NPI assigned

Jan 7, 2008

Organization subpart

No

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

Authorized official

Name

Dr. David S. Shoberg, M.D.

Title

Physician

Phone

(815) 636-7111

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199664000000",
    "number": "1881879088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7144 KLECKNER RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076821",
            "telephone_number": "815-636-7111",
            "fax_number": "815-639-3526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7144 KLECKNER RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076821",
            "telephone_number": "815-636-7111",
            "fax_number": "815-639-3526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKFORD PEDIATRIC PULMONOLOGY, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-07",
        "last_updated": "2008-01-07",
        "status": "A",
        "authorized_official_last_name": "SHOBERG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "815-636-7111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; 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.