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ROCKFORD SURGICAL SERVICE S.C. NPI 1073679411


NPI Information

NPI: 1073679411
Provider Name: ROCKFORD SURGICAL SERVICE, S.C.
Classification: Surgery - 2086S0102X
Entity Type: Organization

Specialization: Surgical Critical Care

Address:
5668 E STATE ST
SUITE1000
ROCKFORD, IL
ZIP 61108
Phone: (815) 397-7900
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ROCKFORD SURGICAL SERVICE, S.C. is a surgical critical care surgery in Rockford, IL. The provider is a surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. ROCKFORD SURGICAL SERVICE, S.C. NPI is 1073679411. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5668 E STATE ST
SUITE1000
ROCKFORD, IL
ZIP 61108-490
Phone: (815) 397-7900
Fax: (815) 397-7919

The provider's authorized official is Leslie P Edgcomb .
The authorized official title is President and has the following contact phone number (815) 397-7900.

The enumeration date for this NPI number is 12/29/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12086S0102XSurgerySurgical Critical Care04200060ILLINOISYes
2208600000XSurgeryILLINOISX
32086S0129XSurgeryVascular SurgeryILLINOISX
4208C00000XColon & Rectal SurgeryILLINOISX
5208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)ILLINOISX

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
110115298OTHERILLINOISBLUE SHIELD
296719OTHERILLINOISRAIL ROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.