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FREDRIC C. KULLBERG M.D.S.C. NPI 1447364740


NPI Information

NPI: 1447364740
Provider Name: FREDRIC C. KULLBERG, M.D.S.C.
Classification: Internal Medicine - 207RP1001X
Entity Type: Organization

Specialization: Pulmonary Disease

Address:
5668 E STATE ST
SUITE B600
ROCKFORD, IL
ZIP 61108
Phone: (815) 397-7212
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FREDRIC C. KULLBERG, M.D.S.C. is a pulmonary disease internal medicine in Rockford, IL. The provider is an internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. FREDRIC C. KULLBERG, M.D.S.C. NPI is 1447364740. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5668 E STATE ST
SUITE B600
ROCKFORD, IL
ZIP 61108-490
Phone: (815) 397-7212
Fax: (815) 397-2539

The provider's authorized official is Fredric C. Kullberg .
The authorized official title is President and has the following contact phone number (815) 397-7212.

The enumeration date for this NPI number is 8/17/2006 and was last updated on 3/11/2008.


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
1207RP1001XInternal MedicinePulmonary DiseaseILLINOISYes

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
1101 00574OTHERILLINOISBLUE CROSS BLUE SHIELD
2666470MEDICARE ID-TYPE UNSPECIFIEDILLINOIS
3C45330MEDICARE UPINILLINOIS

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: 4/28/2024

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