MARY E NOVOTNY NPI 1689056285

NPI Information

NPI: 1689056285
Provider Name: MARY E NOVOTNY
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

Organization: SWEDISHAMERICAN HOSPITAL

PECOS Registration: Yes

Address:
1340 CHARLES ST
SUITE 100
ROCKFORD, IL
ZIP 61104
Phone: (779) 696-8700
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Mary E Novotny is a gerontology nurse practitioner in Rockford, IL with 9 years of experience. Mary E Novotny NPI is 1689056285. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1340 CHARLES ST
SUITE 100
ROCKFORD, IL
ZIP 61104
Phone: (779) 696-8700

The NPI 1689056285 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/19/2015 and was last updated on 2/19/2021.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		041-359227	ILLINOIS	No
2	363LG0600X	Nurse Practitioner	Gerontology	209-013360	ILLINOIS	Yes

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

NPI Synchronization or Removal

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