Advanced Facial Plastics & Mohs

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

Legal business name

ADVANCED FACIAL PLASTICS & MOHS

Practice address

1235 N Mulford Rd
Suite 100
Rockford, IL 61107-3879

Phone

(815) 484-9900

NPI assigned

Sep 28, 2007

Last updated

Nov 8, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kimberly Macmurchy

Title

Contracting and Credentialing

Phone

(815) 484-9900

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194480000000",
    "number": "1922295328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 N MULFORD RD",
            "address_2": "SUITE 100",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611073879",
            "telephone_number": "815-484-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 N MULFORD RD",
            "address_2": "SUITE 100",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611073879",
            "telephone_number": "815-484-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED FACIAL PLASTICS & MOHS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-28",
        "last_updated": "2007-11-08",
        "status": "A",
        "authorized_official_last_name": "MACMURCHY",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CONTRACTING AND CREDENTIALING",
        "authorized_official_telephone_number": "815-484-9900"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebekah Addis, LSW
• Addus Healthcare Inc (Addus HomeCare)
• Adio Chiropractic of Rockford LLC
• Advanced Allergy & ENT, LLC
• Advanced Care & Treatment Medical Group
• Advanced Motion Physical Therapy. PLLC
• Advanced Neuroscience Innovation Institute LLC
• Advanced Pain Intervention SC
• Advanced Reproductive Center, LTD.
• Advanced Rockford Eye Care LLC

• MOHS-Micrographic Surgery Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• MOHS-Micrographic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; 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.