GREGORY BULLIS M.D. NPI 1497784797

NPI Information

NPI: 1497784797
Provider Name: GREGORY BULLIS, M.D.
Classification: Emergency Medicine - 207PE0004X
Entity Type: Individual

Specialization: Emergency Medical Services

Address:
5666 EAST STATE ST
ROCKFORD, IL
ZIP 61108
Phone: (815) 226-2000
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Gregory Bullis, M.D. is an emergency medical services emergency medicine in Rockford, IL. The provider is an emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. Gregory Bullis, M.D. NPI is 1497784797. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5666 EAST STATE ST
ROCKFORD, IL
ZIP 61108-472
Phone: (815) 226-2000
Fax: (815) 381-7582

The enumeration date for this NPI number is 7/1/2006 and was last updated on 11/1/2013.

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	207PE0004X	Emergency Medicine	Emergency Medical Services	036067306	ILLINOIS	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	36067306	MEDICAID	ILLINOIS
2	D16699	MEDICARE UPIN
3	K05805	MEDICARE ID-TYPE UNSPECIFIED	ILLINOIS

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

NPI Synchronization or Removal

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