NPIMap

Organization Active NPI

Rejuvenation LLC

  • Plastic Surgery Physician
  • Rockford, IL
National Provider Identifier
1972926095
Registry record updated Jan 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
036111771 Issued in IL
Legal business name
REJUVENATION LLC
Practice address
3065 N Perryville Rd
Ste 141
Rockford, IL 61114-8053
Phone
(815) 397-3373
NPI assigned
Jan 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2014

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

Authorized official

Name
James S McAdoo, DO
Title
President
Phone
(815) 397-3373

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X 036111771 IL Primary

Addresses

Primary practice location

3065 N Perryville Rd
Ste 141
Rockford, IL 61114-8053

Mailing address

6785 Weaver Rd
Ste D
Rockford, IL 61114-8055
Phone (815) 633-8586

National Provider Directory

National Provider Directory

Locations

6785 Weaver Rd
#D
Rockford, IL 61114

NPI Registry JSON

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

{
    "created_epoch": "1390521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390521600000",
    "number": "1972926095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6785 WEAVER RD",
            "address_2": "STE D",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611148055",
            "telephone_number": "815-633-8586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3065 N PERRYVILLE RD",
            "address_2": "STE 141",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611148053",
            "telephone_number": "815-397-3373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVENATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-24",
        "last_updated": "2014-01-24",
        "status": "A",
        "authorized_official_last_name": "MCADOO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-397-3373",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "IL",
            "license": "036111771",
            "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 Jan 24, 2014; 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.