rockford area - community care alliance of illinois...rockford area boone, mchenry, ogle and...

Provider directoryCommunity Complete (D-SNP) • Community Advantage (HMO)

Boone, McHenry, Ogle and Winnebago CountiesRockford areaPhysicians listed alphabetically by zip code.

H3071_OP P008_099_073015 Accepted 10/2/2015

Provider Directory – Rockford Area

Community Advantage (HMO)

&

Community Complete (HMO D-SNP)

This directory provides a list of the Community Advantage (HMO) and Community Complete (HMO D-SNP) network providers. This directory is for the greater Rockford (IL) area. This directory is current as of March 28, 2016. Some network providers may have been added or removed from our network after this directory was printed. We do not guarantee that each provider is still accepting new members. To get the most up-to-date information about Community Advantage (HMO) and Community Complete (HMO D-SNP) network providers in your area, you can visit www.ccaillinois.com/medicare or call our Member Service Department at 1-855-275-2781, Monday through Friday between 8:00am and 8:00pm. TTY/TDD users should call 711. The provider network may change at any time. You may receive notice when necessary. Community Care Alliance of Illinois, NFP offers Community Advantage (HMO) and Community Complete (HMO D-SNP) under contracts with Medicare and the Illinois Medicaid program. Enrollment in Community Care Alliance of Illinois, NFP depends on contract renewal. This information is available for free in other languages. Please call our Member Services number at 1-855-275-2781; Monday through Friday between the hours of 8 a.m. and 8 p.m.; TTY/TDD users should call 711. Esta información está disponible gratuitamente en otros idiomas. Por favor, llame a Servicios de Miembros s al 1-855-275-2781 de lunes a viernes, de 8 a.m. a 8 p.m.; los usuarios de TTY/TDD deben llamar al 711. H3071_OP P008_099_073015 Accepted 10/2/2015

Section 1 – Introduction This directory provides a list of Community Advantage (HMO) and Community Complete (HMO D-SNP) network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage. You will have to choose one of our network providers who are listed in this directory to be your Primary Care Physician (PCP). The term “PCP” will be used throughout this directory. Generally, you must get your health care services from your PCP. Generally, you must get your health care from your PCP. The “network providers” listed in this directory have agreed to provide you with your health care services. You may go to any of our network providers listed in this directory. However, some services may require a referral. If you have been going to one network provider, you are not required to continue to go to that same provider. In some cases, you may get covered services from non-network providers. Your PCP will provide you with referrals as needed for services that they do not provide themselves, such as specialty care, x-rays and radiology, and laboratory, for example. The PCP also works with our Plan to generate authorizations as required for services such as: hospital or other admissions; day surgeries; physical, occupational or speech therapies, diagnostic radiology (besides x-rays); home heath; on-going specialist care. “Non-plan providers” are providers that are not part of the Community Advantage (HMO) or Community Complete (HMO D-SNP) plan. If you use non-plan providers, you may have to pay more. Care or services you get from non-plan providers will not be covered, except for ambulance services, emergency care, including post-stabilization care, urgently needed care, renal (kidney) dialysis, and any services which were approved through an appeals process. We cover certain health care services that you get from non-plan providers. These include care for a medical emergency, urgently needed care, renal (kidney) dialysis that you get when you are outside the plan’s service area, care that has been approved in advance by Community Care Alliance of Illinois, NFP, and any services which were approved through an appeals process. If a non-plan provider asks you to pay for covered services you get in these situations, please contact us at:

Community Care Alliance of Illinois, NFP 322 S Green St.

Suite 400 Chicago, IL 60607

Or call Member services at 1-855-275-2781

Monday through Friday between 8:00am and 8:00pm for assistance (7 days a week from October 1 through February 14)

TTY/TDD Users call 711

Or visit us at www.ccaillinois.com/medicare

You should never pay any non-plan provider more than what the provider is allowed by Medicare. The provider has a right to get his/her fees, but does not have a right to get them from you. Ask the non-plan provider to bill us first. If you have already paid for the covered services, we will reimburse you for our share of the cost. If you get a bill for the services, you can send the bill to us for payment. We will pay your non-plan provider for our share of the bill and will let you know what, if anything, you must pay. When you are outside the service area and cannot get care from a network provider, our plan will cover urgently needed care that you get from any provider. The only services we cover when you are outside of our service area are care for a medical emergency, including post-stabilization care, urgently needed care, renal (kidney) dialysis, and care that a Community Advantage (HMO) or Community Complete (D-SNP) plan provider has approved in advance. If you have questioned whether a service is covered when you travel please call, Member services at 1-855-275-2781. TTY/TDD Users call 711. As a supplemental benefit to our members, Community Advantage and Community Complete cover emergent and urgently needed care, even if you receive the care outside of the United States. You will need to contact your PCP as soon as possible when you know you need to seek care or after you are stabilized. You must use plan providers except in emergency or urgent care situations. If you obtain routine care from out-of-network providers neither Medicare nor your will be responsible for the costs. What is the service area for the Community Advantage (HMO) and Community Complete (HMO D-SNP) plans? The Illinois counties in our service area are listed below.

Boone McHenry Ogle Winnebago

How do you find Community Advantage (HMO) and Community Complete (HMO D-SNP) providers in your area? The providers are arranged by County in alphabetical order and then by Provider Type. Since all Enrollees need to choose a PCP, PCPs are listed first. In order to find a provider closest to your home, locate your county first, then your zip code. If you have questions about your plan or require assistance in selecting a PCP, please call our Member services at 1-855-275-2781 Monday through Friday between 8:00am and 8:00pm for assistance (7 days a week from October 1 through February 14). TTY Users call 711. Or, visit www.ccaillinois.com/medicare.

Community Care Alliance of Illinois, NFP

Provider Directory

Rockford‐area

Primary Care Providers (PCP’s)

Federally Qualified Health Centers - IL - BOONECRUSADER CLINIC BELVIDEREProvider Type: Federally Qualified Health Centers

Address: 1050 LOGAN AVE , BELVIDERE IL 61008Phone: 815-490-1600 Network: CRUSADER COMMUNITY HEALTH

Pri. Hospital:

Accepting New Patients: Yes

Pri. Specialty: FAMILY PRACTICE Sec. Specialty: PEDIATRICS

NPI: 1780852244

Min. Age: 0 Max. Age: 110

Pri. Language: Sec. Language:

Handicap Access: Yes

Hrs: Mon: 08:00 - 20:00 Tue: 08:00 - 17:00 Wed: 08:00 - 17:00 Thu: 08:00 - 20:00 Fri: 08:00 - 17:00Accepts Medicaid: Yes

CEB #: 1000054581

1

Primary Care Physicians - CCAI, NFP ( Rockford )Member Services: 1-855-275-2781 411 Provider(s) TTY: 711

Nurse Practitioners - IL - BOONEBRICK, GAIL (Female)Provider Type: Nurse Practitioners

Address: 2170 PEARL ST , BELVIDERE IL 61008Phone: 815-547-5461 Network: OSF MEDICAL GROUP

Pri. Hospital:


Pri. Specialty: FAMILY PRACTICE Sec. Specialty:

NPI: 1679724561


Pri. Language: ENGLISH Sec. Language:



CEB #: 1000090232

COBB, JOAN (Female)Provider Type: Nurse Practitioners


Pri. Hospital: SWEDISHAMERICAN HOSPITAL



NPI: 1003282344




Hrs: Mon: 08:00 - 17:00 Tue: 08:00 - 20:00 Wed: 08:00 - 20:00 Thu: 08:00 - 17:00 Fri: 08:00 - 17:00Accepts Medicaid: No

CEB #: 1000094489

EGGERS, ROSE (Female)Provider Type: Nurse Practitioners





NPI: 1689609372


Pri. Language: ENGLISH Sec. Language: SPANISH



CEB #: 1000042845

HADIE, ANGELA (Female)Provider Type: Nurse Practitioners





NPI: 1073941605





CEB #: 1000043598

KITTS FARON, ANGELA (Female)Provider Type: Nurse Practitioners





NPI: 1609242049




Hrs: Mon: 08:00 - 17:30 Tue: 08:00 - 20:00 Wed: 08:00 - 20:00 Thu: 08:00 - 17:30 Fri: 08:00 - 17:00 Sat: 08:00 - 12:00Accepts Medicaid: No

CEB #: 1000094430

2


MCCAIN, RUBY LATOSHA (Female)Provider Type: Nurse Practitioners




Pri. Specialty: INTERNAL MEDICINE Sec. Specialty: GERIATRICS

NPI: 1437530813





CEB #: 1000094478

PATEL, VELISA J (Female)Provider Type: Nurse Practitioners





NPI: 1366810632


Pri. Language: ENGLISH Sec. Language: GUJARATI



CEB #: 1000094461

RUSSELL, ELISSA (Female)Provider Type: Nurse Practitioners

Address: 1700 HENRY LUCKOW LN , BELVIDERE IL 61008Phone: 779-696-8650 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1225316722





CEB #: 1000058889

TAYLOR, JENNIFER (Female)Provider Type: Nurse Practitioners





NPI: 1982030730





CEB #: 1000043542

YONTZ, LYNN (Female)Provider Type: Nurse Practitioners





NPI: 1629052741





CEB #: 1000042946

3


Physicians - IL - BOONEABBAS, SYED (Male)Provider Type: Physicians





NPI: 1972733103





CEB #: 1000043433

BROWN, MARY (Female)Provider Type: Physicians




Pri. Specialty: INTERNAL MEDICINE Sec. Specialty:

NPI: 1750365862




Hrs: Mon: 08:00 - 17:00 Tue: 08:00 - 20:00 Wed: 08:00 - 20:00 Thu: 08:00 - 17:00 Fri: 08:00 - 17:00 Sat: 08:00 - 12:00Accepts Medicaid: Yes

CEB #: 1000042837

DORONILA HUGHES, KATERINA (Female)Provider Type: Physicians

Address: 143 KISHWAUKEE ST , BELVIDERE IL 61008Phone: 8155447400 Network: OSF MEDICAL GROUP

Pri. Hospital: OSF SAINT ANTHONY MEDICAL CENTER



NPI: 1942304456





CEB #: 1000038201

GIAMALVA, ANDREA (Female)Provider Type: Physicians





NPI: 1104146539





CEB #: 1000056996

GORHAM, STEPHANIE (Female)Provider Type: Physicians





NPI: 1023239258





CEB #: 1000039102

4


IRONSIDE, MARY (Female)Provider Type: Physicians

Address: 2170 PEARL ST , BELVIDERE IL 61008Phone: 8153955886 Network: UIC COLLEGE OF MEDICINE AT ROCKFORD




NPI: 1275579658




Hrs: Mon: 08:00 - 17:00 Wed: 08:00 - 17:00Accepts Medicaid: Yes

CEB #: 1000039367

JARADAH, BASIL (Male)Provider Type: Physicians





NPI: 1427368935





CEB #: 1000043476

KELLENBERGER, NEAL (Male)Provider Type: Physicians





NPI: 1427210319





CEB #: 1000038436

MELLISH, DAWN (Female)Provider Type: Physicians





NPI: 1154306082





CEB #: 1000091369

MILLER, KIMBERLY (Female)Provider Type: Physicians





NPI: 1669606281





CEB #: 1000042934

5


MOLINARI, ANTHONY F (Male)Provider Type: Physicians

Address: 1954 GATEWAY CENTER DR , BELVIDERE IL 61008Phone: 8155447400 Network: OSF MEDICAL GROUP

Pri. Hospital:


Pri. Specialty: INTERNAL MEDICINE Sec. Specialty: PEDIATRICS

NPI: 1043290158





CEB #: 1000096009

MORKER, DIVYESH (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1629399399





CEB #: 1000101305

MYERS, RACHEL (Female)Provider Type: Physicians

Address: 1954 GATEWAY CENTER DR , BELVIDERE IL 61008Phone: 815-547-3780 Network: OSF MEDICAL GROUP

Pri. Hospital:

Accepting New Patients: No


NPI: 1013149889





CEB #: 1000096143

OKESON, EDWIN (Male)Provider Type: Physicians





NPI: 1619951019





CEB #: 1000042910

OLORIEGBE, FATIMAH (Female)Provider Type: Physicians





NPI: 1760672554





CEB #: 1000043260

6


PARIKH, RUCHI (Female)Provider Type: Physicians





NPI: 1689992885





CEB #: 1000096196

POCOCK, DAVID (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1447240445




Hrs:Accepts Medicaid: Yes

CEB #: 1000096217

SANDOVAL, WILLIAM (Male)Provider Type: Physicians

Address: 1747 HENRY LUCKLOW LN , BELVIDERE IL 61008Phone: 815-971-2000 Network: ROCKFORD HEALTH PHYSICIANS

Pri. Hospital:



NPI: 1912080912





CEB #: 1000091606

SANZ, JAIME (Male)Provider Type: Physicians





NPI: 1508937772





CEB #: 1000038939

SAPYING, ATISAK (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1982694980





CEB #: 1000096338

7


SIMMONS, MARY (Female)Provider Type: Physicians





NPI: 1457373946





CEB #: 1000039052

SY, LARRY (Male)Provider Type: Physicians





NPI: 1932182995





CEB #: 1000043295

TASHAKORI, MAHTAB (Female)Provider Type: Physicians





NPI: 1508895780


Pri. Language: ENGLISH Sec. Language: PERSIAN/FARSI


Hrs:Sun: 09:00 - 17:0 Mon: 09:00 - 17:00 Tue: 09:00 - 17:00 Wed: 09:00 - 17:00 Thu: 09:00 - 17:00 Fri: 09:00 - 17:00Accepts Medicaid: Yes

CEB #: 1000096312

TILLERY, JEFFRY (Male)Provider Type: Physicians





NPI: 1689602211





CEB #: 1000096304

VAZQUEZ LOZANO, MARIA (Female)Provider Type: Physicians





NPI: 1306132642





CEB #: 1000064195

8


ZAHEER, KASHIF (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1417996729





CEB #: 1000096187


Address: 143 KISHWAUKEE ST , BELVIDERE IL 61008Phone: 8155447400 Network: OSF MEDICAL GROUP




NPI: 1417996729





CEB #: 1000039301

ZAIDI, SYED (Male)Provider Type: Physicians





NPI: 1285949800





CEB #: 1000096271


Address: 13539 IL RTE 76 , POPLAR GROVE IL 61065Phone: 8157650147 Network: OSF MEDICAL GROUP




NPI: 1629399399





CEB #: 1000101336


Address: 13539 IL Rte 76 , POPLAR GROVE IL 61065Phone: 815-765-0427 Network: OSF MEDICAL GROUP




NPI: 1417996729





CEB #: 1000096202

9


Nurse Practitioners - IL - MCHENRYCARMAN, JASON (Male)Provider Type: Nurse Practitioners

Address: 360 STATION DR , CRYSTAL LAKE IL 60014Phone: 8153386600 Network: CENTEGRA PHYSICIAN CARE

Pri. Hospital: CENTEGRA HOSPITAL - MCHENRY



NPI: 1174522825





CEB #: 1000038645

CARMAN, JASON (Male)Provider Type: Nurse Practitioners

Address: 10350 HALIGUS RD , HUNTLEY IL 60142Phone: 8153386600 Network: CENTEGRA PHYSICIAN CARE




NPI: 1174522825





CEB #: 1000038806

MILBORN, VALERIE (Female)Provider Type: Nurse Practitioners





NPI: 1992704662





CEB #: 1000085014

BHATT, VANCHHANA (Female)Provider Type: Nurse Practitioners

Address: 3801 RUNNING BROOK FARM , JOHNSBURG IL 60051Phone: 815-344-7741 Network: FAMILY MEDICINE SPECIALISTS OF MOUNT PROSPECT

Pri. Hospital:



NPI: 1578844478



Handicap Access: No


CEB #: 1000042591

GREEN, ANTOINETTE (Female)Provider Type: Nurse Practitioners


Pri. Hospital:



NPI: 1134409576



Handicap Access: No


CEB #: 1000105943

10


KOWALCZYK, KAREN (Female)Provider Type: Nurse Practitioners


Pri. Hospital:



NPI: 1316189343



Handicap Access: No


CEB #: 1000042676

TAMPARONG, NAOMI (Female)Provider Type: Nurse Practitioners


Pri. Hospital:



NPI: 1922346220



Handicap Access: No


CEB #: 1000042529

ZAMORA, JULIE (Female)Provider Type: Nurse Practitioners


Pri. Hospital:



NPI: 1740690726



Handicap Access: No

Hrs:Sun: 10:00 - 16:0 Tue: 09:00 - 21:00 Wed: 09:00 - 21:00 Thu: 09:00 - 21:00 Fri: 09:00 - 21:00 Sat: 09:00 - 17:00Accepts Medicaid: Yes

CEB #: 1000083844

BRYANT, SUZANNE (Female)Provider Type: Nurse Practitioners

Address: 204 E PRAIRIE ST , MARENGO IL 60152Phone: 8155683000 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1598973018





CEB #: 1000058938

JOHNSON, MEGAN (Female)Provider Type: Nurse Practitioners





NPI: 1760730576





CEB #: 1000058567

11


MCNAMARA, MARY (Female)Provider Type: Nurse Practitioners





NPI: 1972944510





CEB #: 1000058835

CARMAN, JASON (Male)Provider Type: Nurse Practitioners

Address: 2507 RICHMOND RD , MCHENRY IL 60050Phone: 815-338-6600 Network: CENTEGRA PHYSICIAN CARE




NPI: 1174522825





CEB #: 1000084853


Address: 9700 MAIN ST , RICHMOND IL 60071Phone: 815-678-4181 Network: FAMILY MEDICINE SPECIALISTS INC

Pri. Hospital:



NPI: 1578844478





CEB #: 1000106364



Pri. Hospital:



NPI: 1134409576





CEB #: 1000106407



Pri. Hospital:



NPI: 1134409576





CEB #: 1000106407

12




Pri. Hospital:



NPI: 1316189343





CEB #: 1000106427



Pri. Hospital:



NPI: 1922346220





CEB #: 1000106456



Pri. Hospital:



NPI: 1740690726





CEB #: 1000106467

13


Physicians - IL - MCHENRYBREMER, BONNIE (Female)Provider Type: Physicians

Address: 1465 COMMERCE DR , ALGONQIUN IL 60102Phone: 8476580100 Network: CENTEGRA PHYSICIAN CARE




NPI: 1396738894





CEB #: 1000038462

BURRELL, BARBARA (Female)Provider Type: Physicians





NPI: 1417055765





CEB #: 1000039233

THAN, BABY (Female)Provider Type: Physicians


Pri. Hospital:



NPI: 1033371554




Hrs: Mon: 09:00 - 17:00Accepts Medicaid: Yes

CEB #: 1000067523

ALI, MUHAMMAD (Male)Provider Type: Physicians





NPI: 1932201712





CEB #: 1000084837

BAHADUR, SHRUTI (Female)Provider Type: Physicians





NPI: 1508035304





CEB #: 1000084840

14


BREMER, BONNIE (Female)Provider Type: Physicians

Address: 650 DAKOTA ST - STE A, CRYSTAL LAKE IL 60012Phone: 8154556000 Network: CENTEGRA PHYSICIAN CARE




NPI: 1396738894





CEB #: 1000039120

BURRELL, BARBARA (Female)Provider Type: Physicians





NPI: 1417055765





CEB #: 1000039189

CAMODECA, PATRICK (Male)Provider Type: Physicians





NPI: 1013915248





CEB #: 1000038609

KANG, YONG (Female)Provider Type: Physicians





NPI: 1386764884





CEB #: 1000038392

KOSTINSKY, NATALIE (Female)Provider Type: Physicians





NPI: 1205835881





CEB #: 1000038544

15


LACROSSE, MARILYN (Female)Provider Type: Physicians




Pri. Specialty: EMERGENCY MEDICINE Sec. Specialty: PEDIATRICS

NPI: 1255376885





CEB #: 1000085025

LORENC, Z TED (Male)Provider Type: Physicians





NPI: 1902879380





CEB #: 1000095299

PATEL, MANOJ (Male)Provider Type: Physicians





NPI: 1306846670





CEB #: 1000039391

ROSANWO, MATILDA (Female)Provider Type: Physicians





NPI: 1871570978





CEB #: 1000084997

STINSON, WILLIAM (Male)Provider Type: Physicians





NPI: 1336112911





CEB #: 1000038350

16


YANAMADULA, AMITHA (Female)Provider Type: Physicians





NPI: 1972729283


Pri. Language: ENGLISH Sec. Language: TELUGU



CEB #: 1000085011

ALI, MUHAMMAD (Male)Provider Type: Physicians





NPI: 1932201712





CEB #: 1000085058

BAHADUR, SHRUTI (Female)Provider Type: Physicians





NPI: 1508035304





CEB #: 1000084843






NPI: 1013915248





CEB #: 1000038891






NPI: 1386764884





CEB #: 1000039328

17


KHAN, FAZAL (Male)Provider Type: Physicians


Pri. Hospital: CENTEGRA HOSP - MCHENRY



NPI: 1669430567





CEB #: 1000039356

KO, JARED (Male)Provider Type: Physicians





NPI: 1952369753





CEB #: 1000038147






NPI: 1205835881





CEB #: 1000038708

LACROSSE, MARILYN (Female)Provider Type: Physicians




Pri. Specialty: EMERGENCY MEDICINE Sec. Specialty: PEDIATRICS

NPI: 1255376885





CEB #: 1000085028

MCCARTHY, STEVEN (Male)Provider Type: Physicians

Address: 10350 HALIGUS RD - STE B310, HUNTLEY IL 60142Phone: 8153386600 Network: CENTEGRA PHYSICIAN CARE




NPI: 1497765309





CEB #: 1000039136

18


OSADNIK, RENATA (Female)Provider Type: Physicians





NPI: 1902819717





CEB #: 1000038882






NPI: 1306846670





CEB #: 1000038390

PATEL, PIUSHKUMAR (Male)Provider Type: Physicians





NPI: 1447254255





CEB #: 1000039320






NPI: 1871570978





CEB #: 1000085000

SZETO, ANITA (Female)Provider Type: Physicians





NPI: 1073620175





CEB #: 1000039165

19


YU TUNGOL, DEBBIE (Female)Provider Type: Physicians





NPI: 1497958912





CEB #: 1000039121

ALENGO, DAVID (Male)Provider Type: Physicians


Pri. Hospital: MERCY HOSPITAL & MEDICAL CENTER



NPI: 1356335996



Handicap Access: No


CEB #: 1000042471

BELLUCCI JACKSON, JENNIFER (Female)Provider Type: Physicians


Pri. Hospital:



NPI: 1689669293



Handicap Access: No


CEB #: 1000042666

FRODERMAN, TIMOTHY (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1033148903



Handicap Access: No


CEB #: 1000042559

NAYDENOV, TZVETAN (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1134141195



Handicap Access: No

Hrs:Sun: 10:00 - 16:0 Mon: 09:00 - 21:00 Tue: 09:00 - 21:00 Wed: 09:00 - 21:00 Thu: 09:00 - 21:00 Fri: 09:00 - 21:00 Sat: 09:00 - 17:00Accepts Medicaid: Yes

CEB #: 1000064858

20


PENN, MARK (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1639205255



Handicap Access: No


CEB #: 1000105879

AHMAD, TANVEER (Male)Provider Type: Physicians

Address: 21807 W GRANT HWY , MARENGO IL 60152Phone: 815-568-1074 Network: TANVEER AHMAD

Pri. Hospital: CENTEGRA HOSPITAL - WOODSTOCK



NPI: 1093811374





CEB #: 1000060673

LOPEZ, CASSANDRA (Female)Provider Type: Physicians





NPI: 1619125317





CEB #: 1000038819


Address: 556 E GRANT HWY , MARENGO IL 60152Phone: 8155687313 Network: OSF MEDICAL GROUP




NPI: 1417996729





CEB #: 1000039312


Address: 556 E GRANT HWY , MARENGO IL 60152Phone: 8155687313 Network: OSF MEDICAL GROUP




NPI: 1417996729





CEB #: 1000096179

21


ANDERSON, JOHN (Male)Provider Type: Physicians

Address: 4309 W MEDICAL CENTER DR - STE B202, MCHENRY IL 60050Phone: 815-338-6600 Network: CENTEGRA PHYSICIAN CARE




NPI: 1962450049





CEB #: 1000039159

BANGASH, IFZAL (Male)Provider Type: Physicians





NPI: 1437267010





CEB #: 1000079002

BANGASH, IFZAL (Male)Provider Type: Physicians

Address: 4314 W CRYSTAL LAKE RD - STE B, MCHENRY IL 60050Phone: 8153386600 Network: CENTEGRA PHYSICIAN CARE




NPI: 1437267010





CEB #: 1000038977






NPI: 1013915248





CEB #: 1000084848

DAVIS, ERIN (Female)Provider Type: Physicians





NPI: 1215985387





CEB #: 1000038463

22


DEVENNEY, PHILIPPA (Female)Provider Type: Physicians





NPI: 1518189083





CEB #: 1000039190

HUERTA DE HATHAWAY, DANIELA (Female)Provider Type: Physicians

Address: 4309 MEDICAL CENTER DR - STE B205, MCHENRY IL 60050Phone: 8153386600 Network: CENTEGRA PHYSICIAN CARE




NPI: 1235390154





CEB #: 1000084603






NPI: 1386764884





CEB #: 1000084878






NPI: 1205835881





CEB #: 1000084883

MONJE, MARILE (Female)Provider Type: Physicians





NPI: 1730257783





CEB #: 1000038434

23


MOWERY, JAMES (Male)Provider Type: Physicians





NPI: 1225086143





CEB #: 1000039051






NPI: 1306846670





CEB #: 1000085008

POPLI, RAMAN (Male)Provider Type: Physicians

Address: 5415 BULL VALLEY RD , MCHENRY IL 60050Phone: 815-363-6055 Network: DR RAMAN POPLI AND ASSOCIATES




NPI: 1013928712



Handicap Access: No


CEB #: 1000039758






NPI: 1871570978





CEB #: 1000085003

SANCHEZ, OSCAR (Male)Provider Type: Physicians

Address: 5435 BULL VALLEY RD - STE 218, MCHENRY IL 60050Phone: 8155780224 Network: OMSO MEDICAL LTD




NPI: 1164426094




Hrs: Mon: 14:00 - 18:00 Tue: 11:00 - 18:00 Thu: 11:00 - 18:00 Fri: 10:00 - 18:00 Sat: 09:00 - 13:00Accepts Medicaid: Yes

CEB #: 1000038516

24


SKOPEC, JAMES (Male)Provider Type: Physicians





NPI: 1629026539





CEB #: 1000038180

TILOT, THOMAS (Male)Provider Type: Physicians

Address: 5435 BULL VALLEY RD - STE 200, MCHENRY IL 60050Phone: 8153851101 Network: THOMAS C TILOT MD SC




NPI: 1720146400




Hrs: Mon: 08:00 - 17:00 Tue: 08:00 - 17:00 Thu: 08:00 - 17:00 Fri: 08:00 - 17:00 Sat: 07:30 - 11:30Accepts Medicaid: Yes

CEB #: 1000039092

ZAIDI, MAZHAR (Male)Provider Type: Physicians

Address: 3901 MERCY DR , MCHENRY IL 60050Phone: 815-363-9900 Network: GREATER ELGIN FAMILY CARE CENTER

Pri. Hospital:



NPI: 1093729501


Pri. Language: ENGLISH Sec. Language: HINDI

Handicap Access: No


CEB #: 1000042317



Pri. Hospital:



NPI: 1356335996





CEB #: 1000042463



Pri. Hospital:



NPI: 1689669293





CEB #: 1000106205

25




Pri. Hospital:



NPI: 1033148903





CEB #: 1000106398



Pri. Hospital:



NPI: 1134141195





CEB #: 1000106441



Pri. Hospital:



NPI: 1639205255





CEB #: 1000042553

DILLA, ANN (Female)Provider Type: Physicians

Address: 1906 HOLIAN DR , SPRING GROVE IL 60081Phone: 8153386600 Network: CENTEGRA PHYSICIAN CARE




NPI: 1568490977





CEB #: 1000039071

NARANG, ARUN (Male)Provider Type: Physicians

Address: 7432 HANCOCK DR , WONDER LAKE IL 60097Phone: 815-728-0444 Network: ARUN NARANG

Pri. Hospital: CENTEGRA HOSP - WOODSTOCK



NPI: 1952469215



Handicap Access: No


CEB #: 1000062860

26







NPI: 1952469215



Handicap Access: No


CEB #: 1000062860






NPI: 1952469215



Handicap Access: No


CEB #: 1000062860






NPI: 1952469215



Handicap Access: No


CEB #: 1000062860






NPI: 1952469215



Handicap Access: No


CEB #: 1000062860






NPI: 1952469215



Handicap Access: No


CEB #: 1000062860

27







NPI: 1952469215



Handicap Access: No


CEB #: 1000062860






NPI: 1952469215



Handicap Access: No


CEB #: 1000062860

NARANG, SUNITA (Female)Provider Type: Physicians





NPI: 1306904644



Handicap Access: No


CEB #: 1000062879

AHMAD, TANVEER (Male)Provider Type: Physicians

Address: 335 W BLAKELY ST , WOODSTOCK IL 60098Phone: 815-568-1074 Network: TANVEER AHMAD




NPI: 1093811374





CEB #: 1000060678

EMMONS, JOSEPH (Male)Provider Type: Physicians

Address: 3707 DOTY RD - STE C, WOODSTOCK IL 60098Phone: 8153386600 Network: CENTEGRA PHYSICIAN CARE




NPI: 1407804586





CEB #: 1000038313

28


GLOSSON, LISA (Female)Provider Type: Physicians

Address: 3707 DOTY RD - STE G, WOODSTOCK IL 60098Phone: 8153386600 Network: CENTEGRA PHYSICIAN CARE




NPI: 1780642678





CEB #: 1000038566

HASAN, YASMEEN (Female)Provider Type: Physicians

Address: 3707 DOTY RD - STE H, WOODSTOCK IL 60098Phone: 8153386600 Network: CENTEGRA PHYSICIAN CARE




NPI: 1811955636





CEB #: 1000038818

HOFFMAN, MARCEL (Male)Provider Type: Physicians

Address: 3707 DOTY RD - STE D, WOODSTOCK IL 60098Phone: 8153386600 Network: CENTEGRA PHYSICIAN CARE




NPI: 1538119300





CEB #: 1000038342

JUDY, KAREN (Female)Provider Type: Physicians





NPI: 1093763120





CEB #: 1000039209

LORENC, Z TED (Male)Provider Type: Physicians





NPI: 1902879380





CEB #: 1000038173

29


MARTINEZ, DAVID (Male)Provider Type: Physicians





NPI: 1245211259





CEB #: 1000038472

NOFZINGER, PATRICIA (Female)Provider Type: Physicians




Pri. Specialty: PEDIATRICS Sec. Specialty:

NPI: 1457319261





CEB #: 1000067526

PURDY, ROBIN (Male)Provider Type: Physicians

Address: 3707 DOTY RD - STE G, WOODSTOCK IL 60098Phone: 8153386600 Network: CENTEGRA PHYSICIAN CARE




NPI: 1992858195





CEB #: 1000038879

30


Physician Assistant - IL - MCHENRYAIKEN, BRIANA E (Female)Provider Type: Physician Assistant


Pri. Hospital:



NPI: 1649506874



Handicap Access: No


CEB #: 1000042663

BENAGES, JENNIFER K (Female)Provider Type: Physician Assistant


Pri. Hospital:



NPI: 1538462759



Handicap Access: No


CEB #: 1000042617

BLEZIEN, KIMBERLY L (Female)Provider Type: Physician Assistant


Pri. Hospital:



NPI: 1174832257



Handicap Access: No


CEB #: 1000042658

DEGNER, KENNETH L (Male)Provider Type: Physician Assistant


Pri. Hospital:



NPI: 1528287422



Handicap Access: No


CEB #: 1000042625

GOGULA, SUJATHA R (Female)Provider Type: Physician Assistant




Pri. Specialty: PHYSICIAN ASSISTANT Sec. Specialty:

NPI: 1740431758


Pri. Language: ENGLISH Sec. Language: TAGALOG

Handicap Access: No


CEB #: 1000042483

31


MACCALLUM, KATHLEEN M (Female)Provider Type: Physician Assistant


Pri. Hospital:



NPI: 1922170265



Handicap Access: No


CEB #: 1000066438

PRICE, JAMIE (Female)Provider Type: Physician Assistant


Pri. Hospital:



NPI: 1487631958



Handicap Access: No


CEB #: 1000042408

AIKEN, BRIANA E (Female)Provider Type: Physician Assistant


Pri. Hospital:



NPI: 1649506874





CEB #: 1000106146



Pri. Hospital:



NPI: 1538462759





CEB #: 1000106235



Pri. Hospital:



NPI: 1174832257





CEB #: 1000106377

32




Pri. Hospital:



NPI: 1528287422





CEB #: 1000106385






NPI: 1740431758





CEB #: 1000042505



Pri. Hospital:



NPI: 1922170265





CEB #: 1000066466

33


Federally Qualified Health Centers - IL - MCHENRYMCHENRY COMMUNITY HEALTH CTRProvider Type: Federally Qualified Health Centers


Pri. Hospital:



NPI: 1295014116



Handicap Access: No


CEB #: 1000065355

34


Physicians - IL - OGLEGELLADA, KAREN (Female)Provider Type: Physicians

Address: 130 KYSOR DR , BYRON IL 61010Phone: 8159712000 Network: ROCKFORD HEALTH PHYSICIANS

Pri. Hospital: ROCKFORD MEMORIAL HOSPITAL



NPI: 1285897967





CEB #: 1000039250

MYERS, RACHEL (Female)Provider Type: Physicians

Address: 109 N FRANKLIN ST , BYRON IL 61010Phone: 8152343900 Network: OSF MEDICAL GROUP




NPI: 1013149889





CEB #: 1000096139

ROGERS, EMILY (Female)Provider Type: Physicians

Address: 220 W BLACKHAWK DR , BYRON IL 61010Phone: 8152342611 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1386856490





CEB #: 1000039097

FLYNN, TIMOTHY (Male)Provider Type: Physicians

Address: 5665 N JUNCTION WAY , DAVIS JUNCTION IL 61020Phone: 779-696-9200 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1174566038





CEB #: 1000039077

RETZER, DANIEL (Male)Provider Type: Physicians





NPI: 1063455079





CEB #: 1000038782

35


SORIANO, CHRISTINA (Female)Provider Type: Physicians





NPI: 1215215744





CEB #: 1000055405

36


Federally Qualified Health Centers - IL - WINNEBAGOCRUSADER COMMUNITY HEALTHProvider Type: Federally Qualified Health Centers

Address: 6115 N 2ND ST , LOVES PARK IL 61111Phone: 815-490-1600 Network: CRUSADER COMMUNITY HEALTH

Pri. Hospital:



NPI: 1891082194





CEB #: 1000054351

CRUSADER CLINICProvider Type: Federally Qualified Health Centers

Address: 1200 W STATE ST , ROCKFORD IL 61102Phone: 815-490-1600 Network: CRUSADER COMMUNITY HEALTH

Pri. Hospital:


Pri. Specialty: FAMILY PRACTICE Sec. Specialty: OBSTETRICS & GYNECOLOGY

NPI: 1902972557





CEB #: 1000054571

CRUSADER CLINIC BROADWAYProvider Type: Federally Qualified Health Centers

Address: 1100 BROADWAY , ROCKFORD IL 61104Phone: 815-490-1600 Network: CRUSADER COMMUNITY HEALTH

Pri. Hospital:



NPI: 1265601488





CEB #: 1000054345

37


Physicians - IL - WINNEBAGOGO LIM, JOCELYN (Female)Provider Type: Physicians

Address: 1572 S BELL SCHOOL RD , CHERRY VALLEY IL 61016Phone: 8153323015 Network: OSF MEDICAL GROUP




NPI: 1255376471


Pri. Language: ENGLISH Sec. Language: RUSSIAN



CEB #: 1000095794

LIM, EDISON (Male)Provider Type: Physicians

Address: 1572 S BELL SCHOOL RD , CHERRY VALLEY IL 61016Phone: 8153323015 Network: OSF MEDICAL GROUP




NPI: 1215966858





CEB #: 1000095660

ABBAS, SYED (Male)Provider Type: Physicians





NPI: 1972733103





CEB #: 1000043431






NPI: 1750365862





CEB #: 1000042840

DE GUZMAN, PEDRO (Male)Provider Type: Physicians

Address: 9951 ROCK CUT CROSSING , LOVES PARK IL 61111Phone: 8156398500 Network: OSF MEDICAL GROUP




NPI: 1902834229





CEB #: 1000096407

38







NPI: 1427368935





CEB #: 1000043230

KHAN, MOHAMMED (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1679703797





CEB #: 1000095963

KOUIMELIS, MICHAEL (Male)Provider Type: Physicians





NPI: 1033373907


Pri. Language: ENGLISH Sec. Language: GREEK



CEB #: 1000096104

MARCK, MICHAEL (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1720018161





CEB #: 1000095778

MARTENS, MONICA (Female)Provider Type: Physicians





NPI: 1710142740





CEB #: 1000095786

39




Pri. Hospital:



NPI: 1154306082





CEB #: 1000091366






NPI: 1669606281





CEB #: 1000042931


Address: 9951 ROCK CUT CROSSING , LOVES PARK IL 61111Phone: 815-639-8450 Network: OSF MEDICAL GROUP

Pri. Hospital:



NPI: 1629399399





CEB #: 1000101317

MUELLER, JOHN (Male)Provider Type: Physicians





NPI: 1952335333





CEB #: 1000096142






NPI: 1619951019





CEB #: 1000042915

40







NPI: 1760672554





CEB #: 1000042917

PETERSEN, KENNETH (Male)Provider Type: Physicians

Address: 7702 N ALPINE RD , LOVES PARK IL 61111Phone: 8159712000 Network: ROCKFORD HEALTH PHYSICIANS




NPI: 1912017104





CEB #: 1000039213

SHAIR, NUHA (Female)Provider Type: Physicians


Pri. Hospital:



NPI: 1881856821





CEB #: 1000096316






NPI: 1932182995





CEB #: 1000043293






NPI: 1689602211





CEB #: 1000096289

41


TOMACRUZ, MOSES (Male)Provider Type: Physicians





NPI: 1144414921





CEB #: 1000096102






NPI: 1306132642





CEB #: 1000064206

WHELAN, SARAH (Female)Provider Type: Physicians


Pri. Hospital:



NPI: 1477598241





CEB #: 1000096229






NPI: 1417996729





CEB #: 1000096163



Pri. Hospital:



NPI: 1285949800





CEB #: 1000096253

42


TCHAPNDA, LUC (Male)Provider Type: Physicians

Address: 380 IL RT 38 EAST , ROCHELLE IL 61068Phone: 7796969050 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1801044763





CEB #: 1000038809






NPI: 1972733103





CEB #: 1000043436






NPI: 1972733103





CEB #: 1000043440

AGUERO MEDINA, CARLOS (Male)Provider Type: Physicians

Address: 2300 N ROCKTON AVE , ROCKFORD IL 61103Phone: 8159712000 Network: ROCKFORD HEALTH PHYSICIANS




NPI: 1053364349





CEB #: 1000038601


Address: 7219 WALTON ST , ROCKFORD IL 61108Phone: 847-526-2151 Network: FAMILY MEDICINE SPECIALISTS OF ROUND LAKE

Pri. Hospital:



NPI: 1356335996





CEB #: 1000103736

43



Address: 3849 NORTHRIDGE DR , ROCKFORD IL 61114Phone: 815-329-6909 Network: FAMILY MEDICINE SPECIALISTS OF MOUNT PROSPECT

Pri. Hospital:



NPI: 1356335996





CEB #: 1000103777

BARIS, AL (Male)Provider Type: Physicians

Address: 6824 NEWBURG RD , ROCKFORD IL 61108Phone: 7796967610 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1821029091





CEB #: 1000038646

BAUTISTA, ELEANOR (Female)Provider Type: Physicians

Address: 698 FEATHERSTONE RD - STE 250, ROCKFORD IL 61107Phone: 8153994404 Network: OSF MEDICAL GROUP




NPI: 1780669804





CEB #: 1000039360

BAUTISTA, ELEANOR (Female)Provider Type: Physicians

Address: 6861 VILLAGREEN VIEW , ROCKFORD IL 61107Phone: 8152821339 Network: OSF MEDICAL GROUP




NPI: 1780669804





CEB #: 1000039179



Pri. Hospital:



NPI: 1689669293





CEB #: 1000103640

44




Pri. Hospital:



NPI: 1689669293





CEB #: 1000103624

BOPARAI, GURPREET (Male)Provider Type: Physicians

Address: 2404 CHARLES ST , ROCKFORD IL 61108Phone: 7796967910 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1275732091





CEB #: 1000085774






NPI: 1750365862





CEB #: 1000042838






NPI: 1750365862





CEB #: 1000042839

BUCHA, JURATE (Female)Provider Type: Physicians

Address: 3775 N MULFORD RD , ROCKFORD IL 61114Phone: 8156366400 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1760705834





CEB #: 1000038929

45


CARTER, MELINDA (Female)Provider Type: Physicians





NPI: 1871522318





CEB #: 1000038138

CHAU, THIRATH (Female)Provider Type: Physicians

Address: 301 E STATE ST , ROCKFORD IL 61104Phone: 815-668-7810 Network: OAK STREET HEALTH

Pri. Hospital:



NPI: 1285896720





CEB #: 1000087425

COATES, AARON (Male)Provider Type: Physicians

Address: 3401 N PERRYVILLE RD , ROCKFORD IL 61114Phone: 8159712000 Network: ROCKFORD HEALTH PHYSICIANS




NPI: 1871603050





CEB #: 1000038358

COPELAND, DANNY (Male)Provider Type: Physicians





NPI: 1790727766





CEB #: 1000039118

DAVIS, RAYMOND (Male)Provider Type: Physicians





NPI: 1417067604





CEB #: 1000064450

46


DEAN, LESLIE (Female)Provider Type: Physicians

Address: 1221 E STATE ST , ROCKFORD IL 61104Phone: 8159721000 Network: UIC COLLEGE OF MEDICINE AT ROCKFORD




NPI: 1316912462





CEB #: 1000092083

DEMING, RICHARD (Male)Provider Type: Physicians





NPI: 1275562712





CEB #: 1000039101

DEVENNEY, PHILIPPA (Female)Provider Type: Physicians





NPI: 1518189083





CEB #: 1000039380

DUDAS, ANDRZEJ (Male)Provider Type: Physicians





NPI: 1609037308


Pri. Language: ENGLISH Sec. Language: POLISH



CEB #: 1000088156

DURANI, HINA (Male)Provider Type: Physicians





NPI: 1598053654





CEB #: 1000091385

47


EVERSON, RALPH (Male)Provider Type: Physicians





NPI: 1902967391





CEB #: 1000038612

FERRY, TIFFANIE (Female)Provider Type: Physicians





NPI: 1538105093





CEB #: 1000038507



Pri. Hospital:



NPI: 1033148903





CEB #: 1000103786



Pri. Hospital:



NPI: 1033148903





CEB #: 1000103801

GANDER, KEVIN (Male)Provider Type: Physicians





NPI: 1255379863





CEB #: 1000095766

48


GIROD, CHANTAL (Female)Provider Type: Physicians





NPI: 1881620383





CEB #: 1000039297

GLOVSKY, ROBERT (Male)Provider Type: Physicians

Address: 7702 N ALPINE RD , ROCKFORD IL 61111Phone: 8159712000 Network: ROCKFORD HEALTH PHYSICIANS




NPI: 1316057508





CEB #: 1000038346

GUENEV, PERKA (Female)Provider Type: Physicians





NPI: 1205934254





CEB #: 1000038308

GUFFEY, JENNIFER (Female)Provider Type: Physicians





NPI: 1831159508





CEB #: 1000039366

HERDEMAN, DANIEL (Male)Provider Type: Physicians





NPI: 1447293451





CEB #: 1000038149

49







NPI: 1275579658





CEB #: 1000091484






NPI: 1427368935





CEB #: 1000042875






NPI: 1427368935





CEB #: 1000042874

KANTAYYA, VIVEK (Male)Provider Type: Physicians





NPI: 1437132479





CEB #: 1000038957

KAUR, AMANDEEP (Female)Provider Type: Physicians





NPI: 1184875072


Pri. Language: ENGLISH Sec. Language: PUNJABI



CEB #: 1000038816

50


KING, MITCHELL (Male)Provider Type: Physicians





NPI: 1225038276




Hrs: Thu: 08:00 - 13:00Accepts Medicaid: Yes

CEB #: 1000038825

KNABE, BRIAN (Male)Provider Type: Physicians





NPI: 1437192408





CEB #: 1000039003

LEE, KENTON (Male)Provider Type: Physicians





NPI: 1366426397





CEB #: 1000038179

LOPEZ, CASSANDRA (Female)Provider Type: Physicians





NPI: 1619125317





CEB #: 1000038625

MALONEY, MICHAEL (Male)Provider Type: Physicians





NPI: 1164452611





CEB #: 1000095746

51


MARTINEZ, LEYNARD (Male)Provider Type: Physicians

Address: 1340 CHARLES ST - STE 405, ROCKFORD IL 61104Phone: 8159675353 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1780613273





CEB #: 1000039352

MARTINEZ, LEYNARD (Male)Provider Type: Physicians





NPI: 1780613273





CEB #: 1000039225

MATHEW, MAXINE (Female)Provider Type: Physicians

Address: 2350 N ROCKTON AVE , ROCKFORD IL 61103Phone: 815-971-2000 Network: ROCKFORD HEALTH PHYSICIANS




NPI: 1578792511





CEB #: 1000039230

MCDONALD, BRYAN A (Male)Provider Type: Physicians





NPI: 1669582854





CEB #: 1000038276

MEJER, JANUSZ (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1790836807





CEB #: 1000094382

52







NPI: 1154306082





CEB #: 1000091360






NPI: 1154306082





CEB #: 1000091363

MICHALSEN, BRIAN (Male)Provider Type: Physicians





NPI: 1548426158





CEB #: 1000038986






NPI: 1669606281





CEB #: 1000042930






NPI: 1669606281





CEB #: 1000042929

53


MITCHELL, DAVID (Male)Provider Type: Physicians

Address: 5970 CHURCHVIEW DR , ROCKFORD IL 61107Phone: 8159712000 Network: ROCKFORD HEALTH PHYSICIANS




NPI: 1013027200





CEB #: 1000038801

MONKEMEYER, JON (Male)Provider Type: Physicians





NPI: 1114087731





CEB #: 1000038913

MOORE, WILLARD D (Male)Provider Type: Physicians





NPI: 1831209022





CEB #: 1000039373

MUHAMMAD, TRACY (Female)Provider Type: Physicians





NPI: 1033161435





CEB #: 1000038723



Pri. Hospital:



NPI: 1134141195





CEB #: 1000104007

54




Pri. Hospital:



NPI: 1134141195





CEB #: 1000103843

NIKA, VASIL (Male)Provider Type: Physicians





NPI: 1811987886


Pri. Language: ENGLISH Sec. Language: ITALIAN



CEB #: 1000091487

NITZ, STEPHEN (Male)Provider Type: Physicians





NPI: 1518958651




Hrs: Mon: 08:30 - 18:00 Tue: 07:30 - 16:00 Wed: 07:30 - 18:00 Thu: 08:00 - 16:00Accepts Medicaid: Yes

CEB #: 1000038290

NOREM, DENNIS (Male)Provider Type: Physicians





NPI: 1386754570





CEB #: 1000039219

NOWAK, MAGDALENA (Female)Provider Type: Physicians





NPI: 1740439215





CEB #: 1000038792

55







NPI: 1619951019





CEB #: 1000042911






NPI: 1619951019





CEB #: 1000042914






NPI: 1760672554





CEB #: 1000043263






NPI: 1760672554





CEB #: 1000043264



Pri. Hospital:



NPI: 1639205255





CEB #: 1000105859

56




Pri. Hospital:



NPI: 1639205255





CEB #: 1000105882

PHELAN, PETER (Male)Provider Type: Physicians





NPI: 1548358534





CEB #: 1000038331

PLESCIA, JOHN (Male)Provider Type: Physicians





NPI: 1366671463




Hrs: Mon: 09:00 - 12:00 Wed: 09:00 - 12:00 Thu: 09:00 - 12:00 Fri: 09:00 - 12:00Accepts Medicaid: Yes

CEB #: 1000038286

POLIZZOTTO, MICHAEL (Male)Provider Type: Physicians





NPI: 1871595371





CEB #: 1000038327

PRATHIPATI, SUSHMITA (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1740581776





CEB #: 1000093734

57


RACANELLI, VINCENT (Male)Provider Type: Physicians





NPI: 1730299926





CEB #: 1000038458

RAMCHANDANI, KAMLESH (Male)Provider Type: Physicians

Address: 111 N CHURCH ST , ROCKFORD IL 61101Phone: 8159620394 Network: ONE ELEVEN MEDICAL CLINIC

Pri. Hospital: ALEXIAN BROTHERS MEDICAL CENTER



NPI: 1295723021





CEB #: 1000042689

ROGERS, CRAIG (Male)Provider Type: Physicians





NPI: 1548370737





CEB #: 1000039024

ROHRBACHER, MELISSA (Female)Provider Type: Physicians





NPI: 1649349564





CEB #: 1000038847

RONE, ARTHUR (Male)Provider Type: Physicians

Address: 2350 N ROCKTON AVE - STE 302, ROCKFORD IL 61103Phone: 8159712000 Network: ROCKFORD HEALTH PHYSICIANS




NPI: 1457461642





CEB #: 1000038658

58


ROSKA, JOHN (Male)Provider Type: Physicians





NPI: 1679714216





CEB #: 1000038271

ROSS, JOSEPH (Male)Provider Type: Physicians





NPI: 1487682977




Hrs: Mon: 09:00 - 17:00 Wed: 09:00 - 12:00 Fri: 09:00 - 17:00Accepts Medicaid: Yes

CEB #: 1000038931

ROYCE, JEFFREY (Male)Provider Type: Physicians





NPI: 1619910635




Hrs: Mon: 09:00 - 17:00 Wed: 09:00 - 12:00 Fri: 09:00 - 17:00Accepts Medicaid: Yes

CEB #: 1000038589






NPI: 1619910635





CEB #: 1000039229

SALAZAR, JOSE (Male)Provider Type: Physicians





NPI: 1629074216





CEB #: 1000039374

59


SCHERMER, IAN (Male)Provider Type: Physicians





NPI: 1992815187





CEB #: 1000039116

SCHILLER, THOMAS (Male)Provider Type: Physicians





NPI: 1104827641





CEB #: 1000038734

SCHILLER, THOMAS (Male)Provider Type: Physicians

Address: 1401 E STATE ST , ROCKFORD IL 61107Phone: 815-968-4400 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1104827641





CEB #: 1000058712

SCHOENWALD, JOHN (Male)Provider Type: Physicians

Address: 621 ROXBURY RD , ROCKFORD IL 61107Phone: 8153973350 Network: OSF MEDICAL GROUP




NPI: 1992734446





CEB #: 1000096204

SCHROEDER, PAUL (Male)Provider Type: Physicians





NPI: 1578623195





CEB #: 1000038764

60


SCHULTHEIS, MARTINE (Female)Provider Type: Physicians





NPI: 1275829178





CEB #: 1000096223

SOUFAN, BASSAM (Male)Provider Type: Physicians





NPI: 1356451546





CEB #: 1000038694

SOUFAN, BASSAM (Male)Provider Type: Physicians





NPI: 1356451546





CEB #: 1000039287

SRIDHAR, SRIVANI (Female)Provider Type: Physicians





NPI: 1003075318





CEB #: 1000043027

STAGNARO GREEN, ALEX (Male)Provider Type: Physicians

Address: 1601 PARKVIEW AVE , ROCKFORD IL 61107Phone: 815-395-5870 Network: UIC COLLEGE OF MEDICINE AT ROCKFORD



Pri. Specialty: INTERNAL MEDICINE Sec. Specialty: ENDOCRINOLOGY

NPI: 1124052048





CEB #: 1000088287

61


STARKS, GIOVANNA (Female)Provider Type: Physicians





NPI: 1265608293




Hrs: Tue: 13:00 - 17:00 Wed: 13:00 - 12:00 Fri: 09:00 - 17:00Accepts Medicaid: Yes

CEB #: 1000039177

STARKS, WILLIAM (Male)Provider Type: Physicians





NPI: 1164624250





CEB #: 1000038750

STILES, BRUCE (Male)Provider Type: Physicians





NPI: 1780612465





CEB #: 1000038887

STOCKER, ROSE (Male)Provider Type: Physicians





NPI: 1407882038





CEB #: 1000038987






NPI: 1932182995





CEB #: 1000043292

62



Address: 1002 N PIERPONT AVE , ROCKFORD IL 61101Phone: 815-209-9642 Network: CRUSADER COMMUNITY HEALTH




NPI: 1932182995





CEB #: 1000107611






NPI: 1932182995





CEB #: 1000042935






NPI: 1508895780





CEB #: 1000096386

TAWFIK, ATEF (Male)Provider Type: Physicians





NPI: 1629007067


Pri. Language: ENGLISH Sec. Language: ARABIC



CEB #: 1000095718


Address: 4423 MANCHESTER DR , ROCKFORD IL 61109Phone: 8153941391 Network: OSF MEDICAL GROUP

Pri. Hospital:



NPI: 1689602211





CEB #: 1000039311

63







NPI: 1689602211





CEB #: 1000096298

TRAUTMANN, ERIC (Male)Provider Type: Physicians





NPI: 1477599835




Hrs: Mon: 08:00 - 18:00 Tue: 08:00 - 17:00 Wed: 08:00 - 17:00 Fri: 08:00 - 16:00 Sat: 08:00 - 12:00Accepts Medicaid: Yes

CEB #: 1000038853

TULLY, BRYAN (Male)Provider Type: Physicians

Address: 5666 E STATE ST , ROCKFORD IL 61108Phone: 815-226-2000 Network: OSF MEDICAL GROUP



Pri. Specialty: INTERNAL MEDICINE Sec. Specialty: HOSPITALIST

NPI: 1134442213





CEB #: 1000096119

ULMER, MEREDITH (Female)Provider Type: Physicians





NPI: 1720216930





CEB #: 1000039347






NPI: 1306132642





CEB #: 1000064190

64







NPI: 1306132642





CEB #: 1000064183

VILLACORTA, JORGE (Male)Provider Type: Physicians





NPI: 1124064001





CEB #: 1000038773

VOLETY, SNIGDHA (Female)Provider Type: Physicians





NPI: 1821283565





CEB #: 1000039182

WASHINGTON, CHARLES M (Male)Provider Type: Physicians





NPI: 1518077700





CEB #: 1000038839

WASHINGTON, CHARLES M (Male)Provider Type: Physicians





NPI: 1518077700





CEB #: 1000038369

65


WEDEL, PAUL (Male)Provider Type: Physicians





NPI: 1700860764





CEB #: 1000038618

WEISS, SHELDON A (Male)Provider Type: Physicians





NPI: 1427168616





CEB #: 1000038688

WHELAN, SARAH (Female)Provider Type: Physicians





NPI: 1477598241





CEB #: 1000096238

WILLIAMS, ALLEN (Male)Provider Type: Physicians





NPI: 1073601324





CEB #: 1000038378

WILLIAMS, FARION (Male)Provider Type: Physicians





NPI: 1568446516





CEB #: 1000038771

66


WOLLSTADT, LOYD (Male)Provider Type: Physicians





NPI: 1356332498





CEB #: 1000038543

WOODMAN, JAMES (Male)Provider Type: Physicians





NPI: 1932201555





CEB #: 1000039081






NPI: 1417996729





CEB #: 1000096155






NPI: 1285949800





CEB #: 1000096262

ZUG, DIANE (Female)Provider Type: Physicians


Pri. Hospital:



NPI: 1578596227





CEB #: 1000096280

67



Address: 1511 BLACKHAWK BLVD , ROCKTON IL 61072Phone: 8153955879 Network: UIC COLLEGE OF MEDICINE AT ROCKFORD




NPI: 1275579658




Hrs: Tue: 08:00 - 17:00 Thu: 08:00 - 17:00Accepts Medicaid: Yes

CEB #: 1000038606

NIKA, VASIL (Male)Provider Type: Physicians





NPI: 1811987886


Pri. Language: ENGLISH Sec. Language: ITALIAN


Hrs: Tue: 08:30 - 17:00 Wed: 08:30 - 17:00 Thu: 08:30 - 17:00 Fri: 08:30 - 17:00 Sat: 08:30 - 12:00Accepts Medicaid: Yes

CEB #: 1000039392

SHARKEY, CARRIE (Female)Provider Type: Physicians





NPI: 1295725323




Hrs: Tue: 08:30 - 16:00 Fri: 08:00 - 12:00Accepts Medicaid: Yes

CEB #: 1000038237

CRAYS, GAYLE (Female)Provider Type: Physicians

Address: 4282 E ROCKTON RD , ROSCOE IL 61073Phone: 779-696-9000 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1134168586





CEB #: 1000038857

GURTIZEN, JEFFREY (Male)Provider Type: Physicians





NPI: 1922395763





CEB #: 1000091644

68


HANSEN, DAVID L (Male)Provider Type: Physicians

Address: 5000 PRAIRIE ROSE DR , ROSCOE IL 61073Phone: 8159712000 Network: ROCKFORD HEALTH PHYSICIANS




NPI: 1689784878




Hrs: Mon: 17:00 - 20:00 Tue: 17:00 - 20:00 Wed: 17:00 - 20:00 Thu: 17:00 - 20:00 Sat: 10:00 - 16:00Accepts Medicaid: Yes

CEB #: 1000038624

OSKOUEI, SEYYED (Male)Provider Type: Physicians

Address: 4682 E ROCKTON ST - STE 102, ROSCOE IL 61073Phone: 815-624-1300 Network: OSF MEDICAL GROUP

Pri. Hospital:



NPI: 1912136896





CEB #: 1000090346

SEKULIC, DUSICA (Female)Provider Type: Physicians





NPI: 1801906094





CEB #: 1000038578

TAYLOR, JANE (Female)Provider Type: Physicians





NPI: 1588827588





CEB #: 1000090748

MICHALSEN, BRIAN (Male)Provider Type: Physicians

Address: 102 LANDMARK DR , WINNEBAGO IL 61088Phone: 8159712000 Network: ROCKFORD HEALTH PHYSICIANS




NPI: 1548426158





CEB #: 1000038158

69


RUDOLPH, HAHN (Female)Provider Type: Physicians





NPI: 1275643462





CEB #: 1000038504

STRUTZENBERG, JON (Male)Provider Type: Physicians





NPI: 1174633366





CEB #: 1000038200

70


Physician Assistant - IL - WINNEBAGOAIKEN, BRIANA E (Female)Provider Type: Physician Assistant

Address: 3849 NORTHRIDGE DR , ROCKFORD IL 61114Phone: 8159218800 Network: FAMILY MEDICINE SPECIALISTS OF MOUNT PROSPECT

Pri. Hospital:



NPI: 1649506874





CEB #: 1000089162

AIKEN, BRIANA E (Female)Provider Type: Physician Assistant


Pri. Hospital:



NPI: 1649506874





CEB #: 1000105731



Pri. Hospital:



NPI: 1538462759





CEB #: 1000105760



Pri. Hospital:



NPI: 1538462759





CEB #: 1000105753



Pri. Hospital:



NPI: 1174832257





CEB #: 1000105707

71




Pri. Hospital:



NPI: 1174832257





CEB #: 1000105688



Pri. Hospital:



NPI: 1528287422





CEB #: 1000105976



Pri. Hospital:



NPI: 1528287422





CEB #: 1000105985



Pri. Hospital:



NPI: 1740431758





CEB #: 1000105961



Pri. Hospital:



NPI: 1740431758





CEB #: 1000105964

72




Pri. Hospital:



NPI: 1922170265





CEB #: 1000105907



Pri. Hospital:



NPI: 1922170265





CEB #: 1000105914

73


MEDICARE CLINIC - IL - WINNEBAGOOAK STREET HEALTH ROCKFORDProvider Type: MEDICARE CLINIC


Pri. Hospital:



NPI: NULL





CEB #: 1000090732

74


Nurse Practitioners - IL - WINNEBAGOCOBB, JOAN (Female)Provider Type: Nurse Practitioners





NPI: 1003282344





CEB #: 1000094490

EATOCK, CAROLE (Female)Provider Type: Nurse Practitioners


Pri. Hospital:


Pri. Specialty: NURSE PRACTITIONER Sec. Specialty: FAMILY PRACTICE

NPI: 1588964712





CEB #: 1000095775






NPI: 1689609372





CEB #: 1000042848






NPI: 1073941605





CEB #: 1000043492






NPI: 1609242049





CEB #: 1000094431

75







NPI: 1437530813





CEB #: 1000094479






NPI: 1366810632





CEB #: 1000094434






NPI: 1982030730





CEB #: 1000043536






NPI: 1629052741





CEB #: 1000042949

BARR, JESSICA (Female)Provider Type: Nurse Practitioners





NPI: 1124181664





CEB #: 1000038812

76


BEHLING, REBECCA (Female)Provider Type: Nurse Practitioners




Pri. Specialty: FAMILY PRACTICE Sec. Specialty: NURSE PRACTITIONER

NPI: 1508060518





CEB #: 1000039053



Pri. Hospital:



NPI: 1578844478





CEB #: 1000105849



Pri. Hospital:



NPI: 1578844478





CEB #: 1000105845

BOWMAR, ANDREA (Female)Provider Type: Nurse Practitioners




Pri. Specialty: NURSE PRACTITIONER Sec. Specialty:

NPI: 1811382427





CEB #: 1000089396

BRADY, MICHELLE (Female)Provider Type: Nurse Practitioners





NPI: 1396735379





CEB #: 1000094400

77



Address: 2473 MCFARLAND RD , ROCKFORD IL 61107Phone: 8159862286 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1598973018





CEB #: 1000058931

CHRISTIANSEN, BETH (Female)Provider Type: Nurse Practitioners





NPI: 1538199666





CEB #: 1000058411






NPI: 1003282344





CEB #: 1000094488






NPI: 1003282344





CEB #: 1000094491






NPI: 1003282344





CEB #: 1000094484

78


COX RODRIGUEZ, DONNA (Female)Provider Type: Nurse Practitioners





NPI: 1245492537





CEB #: 1000038746

CRAWFORD, STEPHANIE (Female)Provider Type: Nurse Practitioners





NPI: 1053601567





CEB #: 1000038364


Address: 330 15TH AVE , ROCKFORD IL 61104Phone: 815-972-7200 Network: UIC COLLEGE OF MEDICINE AT ROCKFORD




NPI: 1588964712





CEB #: 1000091532






NPI: 1689609372





CEB #: 1000042846






NPI: 1689609372





CEB #: 1000042847

79




Pri. Hospital:



NPI: 1134409576





CEB #: 1000105950



Pri. Hospital:



NPI: 1134409576





CEB #: 1000105936

GURNEY, SARAH (Female)Provider Type: Nurse Practitioners





NPI: 1669800587





CEB #: 1000057032






NPI: 1073941605





CEB #: 1000042849






NPI: 1073941605





CEB #: 1000043494

80


HULSTEDT, JANELLE (Female)Provider Type: Nurse Practitioners





NPI: 1437334935





CEB #: 1000038451

JOHNSON, MEGAN (Female)Provider Type: Nurse Practitioners





NPI: 1760730576





CEB #: 1000058524

JOHNSON, RHONDA (Female)Provider Type: Nurse Practitioners





NPI: 1548388044





CEB #: 1000038572






NPI: 1609242049





CEB #: 1000094426






NPI: 1609242049





CEB #: 1000094433

81







NPI: 1609242049





CEB #: 1000094432



Pri. Hospital:



NPI: 1316189343





CEB #: 1000104079



Pri. Hospital:



NPI: 1316189343





CEB #: 1000104057






NPI: 1437530813





CEB #: 1000094476






NPI: 1437530813





CEB #: 1000094477

82




Pri. Hospital:



NPI: 1972944510





CEB #: 1000058830

MENDELOFF, ELIZABETH (Female)Provider Type: Nurse Practitioners





NPI: 1689682411





CEB #: 1000038787

NICOLOSI, SANDRA (Female)Provider Type: Nurse Practitioners





NPI: 1124226097





CEB #: 1000038529

NORDMAN, PATRICIA (Female)Provider Type: Nurse Practitioners





NPI: 1225028350





CEB #: 1000038185






NPI: 1366810632





CEB #: 1000094457

83







NPI: 1366810632





CEB #: 1000094462






NPI: 1366810632





CEB #: 1000094458

PETHAN, LAURA (Female)Provider Type: Nurse Practitioners





NPI: 1194122861





CEB #: 1000109025

PYCIOR, NOEL (Male)Provider Type: Nurse Practitioners

Address: 1601 PARKVIEW , ROCKFORD IL 61107Phone: 815-395-5861 Network: UIC COLLEGE OF MEDICINE AT ROCKFORD




NPI: 1063507408




Hrs: Mon: 08:30 - 16:30 Wed: 08:30 - 20:00 Thu: 08:30 - 16:30 Fri: 08:00 - 12:00Accepts Medicaid: Yes

CEB #: 1000039034

SCHIER, ANDREA (Female)Provider Type: Nurse Practitioners




Pri. Specialty: INTERNAL MEDICINE Sec. Specialty: NURSE PRACTITIONER

NPI: 1588065353





CEB #: 1000090767

84


STERNHAGEN, DEEANN (Female)Provider Type: Nurse Practitioners





NPI: 1912162629





CEB #: 1000090964



Pri. Hospital:



NPI: 1922346220





CEB #: 1000105899



Pri. Hospital:



NPI: 1922346220





CEB #: 1000105892






NPI: 1982030730





CEB #: 1000043546






NPI: 1982030730





CEB #: 1000043544

85


TRAUM, NICOLE (Female)Provider Type: Nurse Practitioners


Pri. Hospital:



NPI: 1811305758





CEB #: 1000094387

WEBERG, JILL (Female)Provider Type: Nurse Practitioners

Address: 1415 E STATE ST - STE 800, ROCKFORD IL 61104Phone: 7796969120 Network: SWEDISHAMERICAN MEDICAL GROUP



Pri. Specialty: OBSTETRICS & GYNECOLOGY Sec. Specialty: WOMEN'S HEALTH CARE PROVIDER

NPI: 1801879663





CEB #: 1000038898

WOLF, KATHERINE (Female)Provider Type: Nurse Practitioners





NPI: 1386992196





CEB #: 1000058813






NPI: 1629052741





CEB #: 1000042948






NPI: 1629052741





CEB #: 1000042947

86







NPI: 1629052741





CEB #: 1000107523



Pri. Hospital:



NPI: 1740690726





CEB #: 1000104108



Pri. Hospital:



NPI: 1740690726





CEB #: 1000104105






NPI: 1396735379




Hrs: Mon: 08:00 - 12:00 Tue: 08:00 - 17:00 Thu: 08:00 - 17:00Accepts Medicaid: Yes

CEB #: 1000038614






NPI: 1588964712





CEB #: 1000038242

87


GIBBONS, KELLIE (Female)Provider Type: Nurse Practitioners





NPI: 1609173434





CEB #: 1000038693






NPI: 1598973018





CEB #: 1000058941






NPI: 1972944510





CEB #: 1000058838

SCOTT, CORRIE (Female)Provider Type: Nurse Practitioners


Pri. Hospital:


Pri. Specialty: FAMILY PRACTICE Sec. Specialty: GASTROENTEROLOGY

NPI: 1689000424





CEB #: 1000082263


Address: 245 PRAIRIE HILL RD , SOUTH BELOIT IL 61080Phone: 815-389-9252 Network: UIC COLLEGE OF MEDICINE AT ROCKFORD




NPI: 1396735379





CEB #: 1000091524

88


DINGES, JENNIFER (Female)Provider Type: Nurse Practitioners





NPI: 1720148281





CEB #: 1000038495

89


Provider Directory

Rockford‐area Specialists

RADIATION ONCOLOGY - IL - BOONEANDREWS, SAMUEL (Male)Provider Type: Physicians

Address: 1625 S STATE ST , BELVIDERE IL 61008Phone: 8155475441 Network: SWEDISHAMERICAN MEDICAL GROUP



Pri. Specialty: RADIATION ONCOLOGY Sec. Specialty:

NPI: 1851508337





CEB #: 1000032767

1

Specialists - CCAI, NFP ( Rockford )Member Services: 1-855-275-2781 699 Provider(s) TTY: 711

ORTHOPEDIC SURGERY - IL - BOONEANTON, OSCAR (Male)Provider Type: Physicians




Pri. Specialty: ORTHOPEDIC SURGERY Sec. Specialty:

NPI: 1700089729





CEB #: 1000033680

MILOS, STEVEN (Male)Provider Type: Physicians





NPI: 1093839300





CEB #: 1000034289

2


OBSTETRICS & GYNECOLOGY - IL - BOONENALEWAY, KAREN (Female)Provider Type: Nurse Practitioners





NPI: 1457397341





CEB #: 1000042901

AL KHABBAZ, ANTOUN (Male)Provider Type: Physicians





NPI: 1992797260





CEB #: 1000042814

ARYNOVA, BAKYTBUBU (Female)Provider Type: Physicians




Pri. Specialty: OBSTETRICS & GYNECOLOGY Sec. Specialty:

NPI: 1124467253





CEB #: 1000094482

BRANDIS, OLESYA (Female)Provider Type: Physicians





NPI: 1386950319





CEB #: 1000043217

BUSH, AMANDA (Male)Provider Type: Physicians





NPI: 1093950941





CEB #: 1000032874

3


HARB, TAREK (Male)Provider Type: Physicians





NPI: 1598701088





CEB #: 1000042851

NANABAWA, ZAKERA (Female)Provider Type: Physicians





NPI: 1336370188





CEB #: 1000043256

4


PODIATRY - IL - BOONECORCORAN, MICHAEL (Male)Provider Type: Podiatrists




Pri. Specialty: PODIATRY Sec. Specialty:

NPI: 1528374196





CEB #: 1000034588

NIELSEN, JOHN (Male)Provider Type: Podiatrists





NPI: 1821186263





CEB #: 1000033790

5


MIDWIFERY - IL - BOONEBECK, VICKI (Male)Provider Type: Nurse Practitioners




Pri. Specialty: MIDWIFERY Sec. Specialty: WOMEN'S HEALTH CARE PROVIDER

NPI: 1770596751





CEB #: 1000042831

DOBSON, JENNIFER (Female)Provider Type: Nurse Practitioners





NPI: 1386712651





CEB #: 1000042841

HESTRUP, AMANDA (Male)Provider Type: Nurse Practitioners





NPI: 1811244569





CEB #: 1000042858

KEENEY, RENEE (Male)Provider Type: Nurse Practitioners





NPI: 1205115383





CEB #: 1000042876

NGUY, SCOTT (Male)Provider Type: Nurse Practitioners




Pri. Specialty: MIDWIFERY Sec. Specialty: FAMILY PRACTICE

NPI: 1255688719





CEB #: 1000042905

6


WODELL, DEBORAH (Male)Provider Type: Nurse Practitioners





NPI: 1255419495





CEB #: 1000042944

7


NURSE PRACTITIONER - IL - BOONEEATOCK, CAROLE (Female)Provider Type: Nurse Practitioners


Pri. Hospital:



NPI: 1588964712





CEB #: 1000095782

8


FAMILY PRACTICE - IL - BOONEBURKART, COLLEEN (Female)Provider Type: Nurse Practitioners





NPI: 1073785101





CEB #: 1000081355

HITZ, LEONARD (Male)Provider Type: Nurse Practitioners





NPI: 1669555199





CEB #: 1000042865

SCHULTZ, DIANA (Female)Provider Type: Nurse Practitioners





NPI: 1043554918





CEB #: 1000034200

MEADE, KATHLEEN (Female)Provider Type: Nurse Practitioners





NPI: 1447223789





CEB #: 1000095908

DOHERTY, ANDREW (Male)Provider Type: Physician Assistant





NPI: 1962716456





CEB #: 1000033349

9


ENGLUND, KAREN (Female)Provider Type: Physicians





NPI: 1407872591





CEB #: 1000081360

FRANDSEN, DEVN (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1730316043





CEB #: 1000040063






NPI: 1427368935





CEB #: 1000095897

KALEEMUDDIN, MOHAMMED (Male)Provider Type: Physicians





NPI: 1437119450





CEB #: 1000095912

KHAN, ASRA (Female)Provider Type: Physicians





NPI: 1023018322





CEB #: 1000095941

10


LUCIETTO SIERADZKI, THERESE (Male)Provider Type: Physicians


Pri. Hospital:


Pri. Specialty: FAMILY PRACTICE Sec. Specialty: HOSPITALIST

NPI: 1699708636





CEB #: 1000095720



Pri. Hospital:



NPI: 1912136896





CEB #: 1000090367

POLIZZOTTO, MICHAEL (Male)Provider Type: Physicians

Address: 2170 PEARL ST , BELVIDERE IL 61008Phone: 8153955886 Network: UIC COLLEGE OF MEDICINE AT ROCKFORD




NPI: 1871595371





CEB #: 1000033954

QADRI, MUNEEB (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1972815033


Pri. Language: ENGLISH Sec. Language: URDU



CEB #: 1000096259






NPI: 1275829178





CEB #: 1000081411

11


SY, ESTHER (Female)Provider Type: Physicians





NPI: 1659358703





CEB #: 1000096368

TRAN, MONICA (Female)Provider Type: Physicians





NPI: 1184856155





CEB #: 1000081427






NPI: 1184856155





CEB #: 1000035954

12


WOMEN'S HEALTH CARE PROVIDER - IL - BOONEHOYER, ERICA (Female)Provider Type: Nurse Practitioners




Pri. Specialty: WOMEN'S HEALTH CARE PROVIDER Sec. Specialty: ADVANCED PRACTICE NURSE

NPI: 1104259894





CEB #: 1000058895

13


OPTOMETRY - IL - BOONELERDVORATAVEE, VASANA (Male)Provider Type: Optometrists




Pri. Specialty: OPTOMETRY Sec. Specialty:

NPI: 1356332423





CEB #: 1000043306

WEINGART, RONALD (Male)Provider Type: Optometrists





NPI: 1639169998





CEB #: 1000043313

14


ALLERGY & IMMUNOLOGY - IL - BOONEMOHIUDDIN, FATIMA (Male)Provider Type: Physicians




Pri. Specialty: ALLERGY & IMMUNOLOGY Sec. Specialty: PEDIATRIC ALLERGY & IMMUNOLOGY

NPI: 1578674834





CEB #: 1000035403

15


CARDIOTHORACIC SURGERY - IL - BOONEMYERS, JOHN (Male)Provider Type: Physicians




Pri. Specialty: CARDIOTHORACIC SURGERY Sec. Specialty:

NPI: 1174553523





CEB #: 1000034493

16


PSYCHIATRY - IL - BOONERIZVI, ZAFFAR (Male)Provider Type: Physicians




Pri. Specialty: PSYCHIATRY Sec. Specialty:

NPI: 1730257056





CEB #: 1000043282

17


NEUROLOGY - IL - BOONEROTH, TERRY R (Male)Provider Type: Physicians




Pri. Specialty: NEUROLOGY Sec. Specialty:

NPI: 1215919816





CEB #: 1000043560

18


HEMATOLOGY & MEDICAL ONCOLOGY - IL - BOONESCHULZ, WILLIAM (Male)Provider Type: Physicians




Pri. Specialty: HEMATOLOGY & MEDICAL ONCOLOGY Sec. Specialty:

NPI: 1558382069





CEB #: 1000034989

19


INFECTIOUS DISEASE - IL - BOONEHOMANN, SCOTT (Male)Provider Type: Physicians




Pri. Specialty: INFECTIOUS DISEASE Sec. Specialty:

NPI: 1689674541





CEB #: 1000043402

SHAH, NEHA S (Female)Provider Type: Physicians





NPI: 1629251715





CEB #: 1000043417

TSARAS, GEOFFREY (Male)Provider Type: Physicians





NPI: 1023278769





CEB #: 1000043428

20


VASCULAR NEUROLOGY - IL - BOONESIMIONESCU, MONICA (Female)Provider Type: Physicians




Pri. Specialty: VASCULAR NEUROLOGY Sec. Specialty: NEUROLOGY

NPI: 1184776403





CEB #: 1000043572

21


EMERGENCY MEDICINE - IL - BOONECOLLA, JOSEPH (Male)Provider Type: Physicians




Pri. Specialty: EMERGENCY MEDICINE Sec. Specialty:

NPI: 1003865403





CEB #: 1000091862

TUSCHEN, JAMES (Male)Provider Type: Physicians





NPI: 1639195514





CEB #: 1000096136

22


PAIN MANAGEMENT - IL - BOONEWOJCIECHOWSKI, TAMARA (Female)Provider Type: Nurse Practitioners




Pri. Specialty: PAIN MANAGEMENT Sec. Specialty:

NPI: 1952359861





CEB #: 1000043528

23


PULMONARY DISEASE - IL - BOONETHAPPA, VIVEK (Male)Provider Type: Physicians




Pri. Specialty: PULMONARY DISEASE Sec. Specialty:

NPI: 1295743383





CEB #: 1000033678

ZEATER, MOHAMED (Male)Provider Type: Physicians





NPI: 1285690958





CEB #: 1000035917

24


SOCIAL WORKER - IL - MCHENRYBROWN, VICTORIA (Female)Provider Type: Clinical Social Worker

Address: 1100 COUGAR TRAIL , CARY IL 60013Phone: 8882912538 Network: PSYCHEALTH, LTD.

Pri. Hospital:


Pri. Specialty: SOCIAL WORKER Sec. Specialty:

NPI: 1356448021





CEB #: 1000035108

BROWN, VICTORIA (Female)Provider Type: Clinical Social Worker

Address: 4405 3 OAKS RD - STE B, CRYSTAL LAKE IL 60014Phone: 8882912538 Network: PSYCHEALTH, LTD.

Pri. Hospital:



NPI: 1356448021





CEB #: 1000033718

25


NEPHROLOGY - IL - MCHENRYARORA, AMIT (Male)Provider Type: Physicians

Address: 390 CONGRESS PKWY - STE C, CRYSTAL LAKE IL 60014Phone: 815-301-1001 Network: NEPHROLOGY ASSOCIATES OF NORTHERN ILLINOIS

Pri. Hospital:


Pri. Specialty: NEPHROLOGY Sec. Specialty:

NPI: 1831378330





CEB #: 1000083447

BANGASH, FARHAN (Male)Provider Type: Physicians

Address: 650 E TERRA COTTA AVE - STE 103, CRYSTAL LAKE IL 60014Phone: 224-238-3211 Network: KIDNEY CARE CENTER OF ELGIN LLC DBA KIDNEY CARE




NPI: 1750549473





CEB #: 1000085783

BECTOR, SUMIT (Female)Provider Type: Physicians


Pri. Hospital:



NPI: 1487831202





CEB #: 1000083438

ROSNER, KAROL (Female)Provider Type: Physicians


Pri. Hospital:



NPI: 1053425884





CEB #: 1000083426

CRONIN, DONALD (Male)Provider Type: Physicians

Address: 912 NORTHWEST HWY - STE 206, FOX RIVER GROVE IL 60021Phone: 8478670049 Network: ASSOCIATES IN NEPHROLOGY SC

Pri. Hospital:


Pri. Specialty: NEPHROLOGY Sec. Specialty: INTERNAL MEDICINE

NPI: 1144288739




Hrs: Mon: 12:00 - 17:00 Wed: 12:00 - 16:00Accepts Medicaid: Yes

CEB #: 1000033437

26


PAIN MANAGEMENT - IL - MCHENRYCAROBENE, HOLLY (Female)Provider Type: Physicians

Address: 360 STATION DR - STE 100, CRYSTAL LAKE IL 60014Phone: 815-477-0174 Network: COMPREHENSIVE PAIN CARE

Pri. Hospital:



NPI: 1326140633





CEB #: 1000093826

27


ALLERGY & IMMUNOLOGY - IL - MCHENRYCHUDWIN, DAVID (Male)Provider Type: Physicians

Address: 5911 NW HWY - STE 208, CRYSTAL LAKE IL 60014Phone: 815-455-7289 Network: ALLERGY & ASTHMA ASSOCIATION LTD

Pri. Hospital:


Pri. Specialty: ALLERGY & IMMUNOLOGY Sec. Specialty:

NPI: 1669472262




Hrs: Mon: 12:00 - 18:00 Tue: 10:00 - 17:00 Wed: 12:00 - 18:00 Fri: 10:00 - 16:00Accepts Medicaid: Yes

CEB #: 1000084087

SONENTHAL, KATHY (Female)Provider Type: Physicians

Address: 5911 NW HWY - STE 208, CRYSTAL LAKE IL 60014Phone: 815-455-7289 Network: ALLERGY & ASTHMA ASSOCIATION LTD

Pri. Hospital:



NPI: 1265452940





CEB #: 1000084061

28


OBSTETRICS & GYNECOLOGY - IL - MCHENRYFORSTER, KELLY (Female)Provider Type: Nurse Practitioners





NPI: 1649514316



Handicap Access: No


CEB #: 1000042416

HERING, LEONARD (Male)Provider Type: Physicians





NPI: 1376549964





CEB #: 1000034556

JATTA, BINN (Female)Provider Type: Physicians





NPI: 1255565115





CEB #: 1000084617


Address: 4309 W MEDICAL CENTER DR - STE B305, MCHENRY IL 60050Phone: 8153386600 Network: CENTEGRA PHYSICIAN CARE




NPI: 1376549964





CEB #: 1000034192






NPI: 1376549964



Handicap Access: No


CEB #: 1000042345

29







NPI: 1255565115



Handicap Access: No


CEB #: 1000042380






NPI: 1255565115





CEB #: 1000084614

MURPHY, DARBY (Male)Provider Type: Physicians

Address: 3703 DOTY RD - STE 1, WOODSTOCK IL 60098Phone: 8153386600 Network: CENTEGRA PHYSICIAN CARE




NPI: 1043474703





CEB #: 1000035363

30


RHEUMATOLOGY - IL - MCHENRYKOZLOWSKI, STEPHEN (Male)Provider Type: Physicians




Pri. Specialty: RHEUMATOLOGY Sec. Specialty:

NPI: 1285749390





CEB #: 1000084746

31


CARDIOLOGY - IL - MCHENRYANGELES, EMMANUEL (Male)Provider Type: Nurse Practitioners

Address: 2971 W ALGONQUIN RD , ALGONQUIN IL 60102Phone: 847-683-7099 Network: PRESENCE HEALTH PARTNERS SAINT JOSEPH - CHICAGO

Pri. Hospital: PRESENCE SAINT JOSEPH HOSPITAL - ELGIN


Pri. Specialty: CARDIOLOGY Sec. Specialty:

NPI: 1629310503





CEB #: 1000091147

AKRAMI, BRIAN (Male)Provider Type: Physicians




Pri. Specialty: CARDIOLOGY Sec. Specialty: INTERVENTIONAL CARDIOLOGY

NPI: 1750320958





CEB #: 1000036019

SATEESHA, PRIYA (Female)Provider Type: Physicians

Address: 650 DAKOTA ST - STE A, CRYSTAL LAKE IL 60012Phone: 815-759-8070 Network: CENTEGRA PHYSICIAN CARE



Pri. Specialty: CARDIOLOGY Sec. Specialty: INTERNAL MEDICINE

NPI: 1699939892





CEB #: 1000100474

TOMASIAN, DOUGLAS (Male)Provider Type: Physicians





NPI: 1922187756





CEB #: 1000032581


Address: 360 N TERRA COTTA RD - STE C, CRYSTAL LAKE IL 60012Phone: 815-759-8070 Network: CENTEGRA PHYSICIAN CARE




NPI: 1922187756





CEB #: 1000102596

32


TRAGER, JASON (Male)Provider Type: Physicians





NPI: 1063535417





CEB #: 1000033698


Address: 10350 HALIGUS RD , HUNTLEY IL 60142Phone: 815-759-8070 Network: CENTEGRA PHYSICIAN CARE




NPI: 1699939892





CEB #: 1000100479

AKRAMI, BRIAN (Male)Provider Type: Physicians





NPI: 1750320958





CEB #: 1000034229

KIZILBASH, MOHAMMAD (Male)Provider Type: Physicians





NPI: 1114162948





CEB #: 1000084664






NPI: 1699939892





CEB #: 1000085043

33







NPI: 1922187756





CEB #: 1000034083






NPI: 1063535417





CEB #: 1000032660


Address: 3707 DOTY RD , WOODSTOCK IL 60098Phone: 8153386600 Network: CENTEGRA PHYSICIAN CARE




NPI: 1922187756





CEB #: 1000032668


Address: 3707 DOTY RD - STE E, WOODSTOCK IL 60098Phone: 8153386600 Network: CENTEGRA PHYSICIAN CARE




NPI: 1063535417





CEB #: 1000035374

34


NEUROLOGY - IL - MCHENRYNAGER, BENJAMIN (Male)Provider Type: Physicians

Address: 1122 N MAIN ST , ALGONQUIN IL 60102Phone: 8478547250 Network: CENTEGRA PHYSICIAN CARE




NPI: 1508824376





CEB #: 1000033146

UPCHURCH, TIMOTHY (Male)Provider Type: Physicians

Address: 1122 N MAIN ST , ALGONQUIN IL 60102Phone: 8478547250 Network: CENTEGRA PHYSICIAN CARE




NPI: 1689628745





CEB #: 1000085051

GRINDSTAFF, PAUL (Male)Provider Type: Physicians

Address: 750 E TERRA COTTA AVE - STE A, CRYSTAL LAKE IL 60014Phone: 8154551800 Network: CENTEGRA PHYSICIAN CARE




NPI: 1811948854





CEB #: 1000034013

NAGER, BENJAMIN (Male)Provider Type: Physicians





NPI: 1508824376





CEB #: 1000034162

UPCHURCH, TIMOTHY (Male)Provider Type: Physicians





NPI: 1689628745





CEB #: 1000084765

35


HEMATOLOGY & MEDICAL ONCOLOGY - IL - MCHENRYKARBASIAN ESFAHANI, MERAT (Male)Provider Type: Physicians

Address: 101 W SECOND ST - STE 130, DIXON IL 60102Phone: 8154894722 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1992740963





CEB #: 1000035873

SHIPP, SHARON (Male)Provider Type: Physicians

Address: 101 W SECOND ST - STE 130, DIXON IL 60102Phone: 8154894722 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1427079938





CEB #: 1000034812

36


ENDOCRINOLOGY - IL - MCHENRYAHMED, ACHAL (Male)Provider Type: Physicians




Pri. Specialty: ENDOCRINOLOGY Sec. Specialty:

NPI: 1942421144





CEB #: 1000035290

GOGINENI, JYOTHI (Female)Provider Type: Physicians




Pri. Specialty: ENDOCRINOLOGY Sec. Specialty: INTERNAL MEDICINE

NPI: 1265624282





CEB #: 1000084741

AHMED, ACHAL (Male)Provider Type: Physicians





NPI: 1942421144





CEB #: 1000034813

GOGINENI, JYOTHI (Female)Provider Type: Physicians





NPI: 1265624282





CEB #: 1000084738

PATURI, SHALINI (Male)Provider Type: Physicians

Address: 2000 LAKE AVE , WOODSTOCK IL 60098Phone: 815-337-7100 Network: ROCKFORD HEALTH PHYSICIANS

Pri. Hospital:



NPI: 1215191754





CEB #: 1000091089

37


GENERAL SURGERY - IL - MCHENRYCHEREGI, JOHN (Male)Provider Type: Physicians




Pri. Specialty: GENERAL SURGERY Sec. Specialty:

NPI: 1760632384





CEB #: 1000035179

HEYDARI, AMIR (Male)Provider Type: Physicians





NPI: 1417945437


Pri. Language: ENGLISH Sec. Language: FRENCH



CEB #: 1000084813






NPI: 1417945437





CEB #: 1000084816

LEE, EUGENE (Male)Provider Type: Physicians





NPI: 1306835244





CEB #: 1000084819

SANDSTROM, TODD (Male)Provider Type: Physicians





NPI: 1972583029





CEB #: 1000084831

38


TSEIS ROGINSKY, ALEXANDRA (Female)Provider Type: Physicians





NPI: 1306933197





CEB #: 1000084828






NPI: 1417945437





CEB #: 1000085031

SCHWAAB, AARON (Male)Provider Type: Physicians

Address: 4309 MEDICAL CENTER DR - STE A210, MCHENRY IL 60050Phone: 815-759-2830 Network: CENTEGRA PHYSICIAN CARE




NPI: 1881682805





CEB #: 1000084834

LEE, EUGENE (Male)Provider Type: Physicians

Address: 3707 DOTY RD - STE B, WOODSTOCK IL 60098Phone: 815-206-5540 Network: CENTEGRA PHYSICIAN CARE




NPI: 1306835244





CEB #: 1000084822

39


NURSE PRACTITIONER - EMERGENCY MEDICINE - IL - MCHENRYFREEMAN, LAWRENCE (Male)Provider Type: Nurse Practitioners


Pri. Hospital:


Pri. Specialty: NURSE PRACTITIONER - EMERGENCY MEDICINE Sec. Specialty:

NPI: 1073804258





CEB #: 1000106624

40


FAMILY PRACTICE - IL - MCHENRYPERUMAL, SINDHU (Female)Provider Type: Physicians




Pri. Specialty: FAMILY PRACTICE Sec. Specialty: OCCUPATIONAL & ENVIRONMENTAL MEDICINE

NPI: 1740494236





CEB #: 1000032583

PHASOUK, RYAN (Male)Provider Type: Physicians





NPI: 1215946892





CEB #: 1000033924






NPI: 1659358703





CEB #: 1000035385






NPI: 1124064001





CEB #: 1000033815






NPI: 1821283565





CEB #: 1000035883

41


PERUMAL, SINDHU (Female)Provider Type: Physicians





NPI: 1740494236





CEB #: 1000033641

PERUMAL, SINDHU (Female)Provider Type: Physicians

Address: 3701 DOTY RD - STE C, WOODSTOCK IL 60098Phone: 815-759-4224 Network: CENTEGRA PHYSICIAN CARE




NPI: 1740494236





CEB #: 1000033910

42


INTERNAL MEDICINE - IL - MCHENRYMEHTA, SONIA (Female)Provider Type: Physicians





NPI: 1265459895





CEB #: 1000085017

ALIC, LINDA (Female)Provider Type: Physicians

Address: 4309 MEDICAL CENTER DR - STE A102, MCHENRY IL 60050Phone: 875-759-4323 Network: CENTEGRA PHYSICIAN CARE




NPI: 1235197161





CEB #: 1000102280


Address: 4301 W MEDICAL CENTER DR , MCHENRY IL 60050Phone: 815-338-6600 Network: CENTEGRA PHYSICIAN CARE




NPI: 1235197161





CEB #: 1000035699


Address: 3701 DOTY RD , WOODSTOCK IL 60098Phone: 815-338-2500 Network: CENTEGRA PHYSICIAN CARE




NPI: 1235197161





CEB #: 1000035588

43


ORTHOPEDIC SURGERY - IL - MCHENRYFERRY, SCOTT (Male)Provider Type: Physicians

Address: 750 TERRA COTTA AVE , CRYSTAL LAKE IL 60014Phone: 815-398-9491 Network: ROCKFORD ORTHOPEDIC ASSOCIATES, LTD

Pri. Hospital:



NPI: 1417178385





CEB #: 1000107807

BERG, JAMES (Male)Provider Type: Physicians

Address: 618 S ILLINOIS RTE 31 - STE D, MCHENRY IL 60050Phone: 815-344-1400 Network: ADVANCED ORTHOPAEDIC CENTER




NPI: 1679798326





CEB #: 1000061692

ELSTROM, JOHN A (Male)Provider Type: Physicians

Address: 406 N FRONT ST - STE A, MCHENRY IL 60050Phone: 815-344-3050 Network: JOHN A ELSTROM MD PC




NPI: 1689670200



Handicap Access: No

Hrs: Mon: 08:30 - 17:00 Tue: 09:00 - 17:00 Thu: 08:30 - 17:00 Fri: 10:00 - 14:00Accepts Medicaid: Yes

CEB #: 1000089060

HALL, ROBERT (Male)Provider Type: Physicians

Address: 406 N FRONT ST - STE A, MCHENRY IL 60050Phone: 815-344-3050 Network: JOHN A ELSTROM MD PC




NPI: 1083610612



Handicap Access: No


CEB #: 1000089063

44


CHIROPRACTOR - IL - MCHENRYDOWELL, MARK (Male)Provider Type: Chiropractors

Address: 200 E CONGRESS PKWY , CRYSTAL LAKE IL 60014Phone: 815-338-6600 Network: CENTEGRA PHYSICIAN CARE



Pri. Specialty: CHIROPRACTOR Sec. Specialty:

NPI: 1992854566





CEB #: 1000085055

DAVID, RANDY (Male)Provider Type: Chiropractors

Address: 10350 HALIGUS RD - STE D, HUNTLEY IL 60142Phone: 8153386600 Network: CENTEGRA PHYSICIAN CARE




NPI: 1578553004


Pri. Language: ENGLISH Sec. Language: MALAYALAM



CEB #: 1000033117

SPENGEL, SCOTT (Male)Provider Type: Chiropractors





NPI: 1285641597





CEB #: 1000085046

DOWELL, MARK (Male)Provider Type: Chiropractors





NPI: 1992854566





CEB #: 1000035165

45


PEDIATRIC CARDIOLOGY - IL - MCHENRYFORAN, RONALD (Male)Provider Type: Physicians

Address: 3701 DOTY RD , WOODSTOCK IL 60098Phone: 815-338-2500 Network: OSF MEDICAL GROUP



Pri. Specialty: PEDIATRIC CARDIOLOGY Sec. Specialty:

NPI: 1710980396





CEB #: 1000033105

46


FAMILY PRACTICE - IL - OGLEBRENDEL, KELLY (Female)Provider Type: Nurse Practitioners

Address: 220 W BLACKHAWK DR , BYRON IL 61010Phone: 779-696-1300 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1407269236





CEB #: 1000091734

OMALLEY, MAGGIE (Male)Provider Type: Nurse Practitioners





NPI: 1821346297





CEB #: 1000035215

47


SURGERY - COLON & RECTAL - IL - OGLEPRABHAKAR, LAWRENCE (Male)Provider Type: Physicians

Address: 900 N 2ND ST , ROCHELLE IL 61068Phone: 8155622181 Network: OSF MEDICAL GROUP

Pri. Hospital:


Pri. Specialty: SURGERY - COLON & RECTAL Sec. Specialty:

NPI: 1467482828





CEB #: 1000108449

48


MIDWIFERY - IL - WINNEBAGOBECK, VICKI (Male)Provider Type: Nurse Practitioners





NPI: 1770596751





CEB #: 1000042834






NPI: 1386712651





CEB #: 1000042844






NPI: 1811244569





CEB #: 1000042861






NPI: 1205115383





CEB #: 1000042879






NPI: 1255688719





CEB #: 1000042908

49







NPI: 1255419495





CEB #: 1000042941

BECK, VICKI (Male)Provider Type: Nurse Practitioners





NPI: 1770596751





CEB #: 1000107560


Address: 1100 BROADWAY , ROCKFORD IL 61104Phone: 8154901600 Network: CRUSADER COMMUNITY HEALTH




NPI: 1770596751





CEB #: 1000042832






NPI: 1770596751





CEB #: 1000042833

BOETTNER, KAREN (Male)Provider Type: Nurse Practitioners





NPI: 1669438230





CEB #: 1000033213

50


BOETTNER, KAREN (Male)Provider Type: Nurse Practitioners





NPI: 1669438230





CEB #: 1000055582

CAILLER, LAURA (Female)Provider Type: Nurse Practitioners




Pri. Specialty: MIDWIFERY Sec. Specialty:

NPI: 1003206756





CEB #: 1000090780

CASCIO, PAULA (Male)Provider Type: Nurse Practitioners




Pri. Specialty: MIDWIFERY Sec. Specialty: OBSTETRICS & GYNECOLOGY

NPI: 1629100037





CEB #: 1000034744






NPI: 1386712651





CEB #: 1000042843






NPI: 1386712651





CEB #: 1000042842

51







NPI: 1811244569





CEB #: 1000042860






NPI: 1811244569





CEB #: 1000107450






NPI: 1811244569





CEB #: 1000042859






NPI: 1205115383





CEB #: 1000042878






NPI: 1205115383





CEB #: 1000107525

52







NPI: 1205115383





CEB #: 1000042877






NPI: 1255688719





CEB #: 1000042906






NPI: 1255688719





CEB #: 1000107104






NPI: 1255688719





CEB #: 1000042907






NPI: 1255419495





CEB #: 1000042943

53







NPI: 1255419495





CEB #: 1000107546






NPI: 1255419495





CEB #: 1000042942

54


OPTOMETRY - IL - WINNEBAGOLERDVORATAVEE, VASANA (Male)Provider Type: Optometrists





NPI: 1356332423





CEB #: 1000043312






NPI: 1639169998





CEB #: 1000043319

LERDVORATAVEE, VASANA (Male)Provider Type: Optometrists





NPI: 1356332423





CEB #: 1000043307

LERDVORATAVEE, VASANA (Male)Provider Type: Optometrists





NPI: 1356332423





CEB #: 1000043308






NPI: 1639169998





CEB #: 1000107128

55







NPI: 1639169998





CEB #: 1000043316






NPI: 1639169998





CEB #: 1000043317

56


EMERGENCY MEDICINE - IL - WINNEBAGOTUSCHEN, JAMES (Male)Provider Type: Physicians





NPI: 1639195514





CEB #: 1000096130

MACNEAL, JAMES (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1366692287





CEB #: 1000093687

PATEL, ILAXI (Female)Provider Type: Physicians


Pri. Hospital:


Pri. Specialty: EMERGENCY MEDICINE Sec. Specialty: INTERNAL MEDICINE

NPI: 1629087861





CEB #: 1000091633

57


PULMONARY DISEASE - IL - WINNEBAGOALBAZZAZ, FAIQ J (Male)Provider Type: Physicians




Pri. Specialty: PULMONARY DISEASE Sec. Specialty: INTERNAL MEDICINE

NPI: 1639125750





CEB #: 1000034198

ALTAYEH, ABDULLAH (Male)Provider Type: Physicians




Pri. Specialty: PULMONARY DISEASE Sec. Specialty: CRITICAL CARE MEDICINE

NPI: 1831191584





CEB #: 1000034818

INGRASSIA, THEODORE (Male)Provider Type: Physicians

Address: 5668 E STATE ST - STE B600, ROCKFORD IL 61108Phone: 8153977212 Network: THEODORE S INGRASSIA III MD SC




NPI: 1437263662




Hrs: Mon: 13:00 - 15:00 Wed: 13:00 - 15:00 Thu: 10:00 - 12:00Accepts Medicaid: Yes

CEB #: 1000034867

KULLBERG, FREDRIC (Male)Provider Type: Physicians

Address: 5668 E STATE ST , ROCKFORD IL 61108Phone: 815-397-7212 Network: FREDRIC C KULLBERG MD SC




NPI: 1912010273





CEB #: 1000034318

PONNAMBALAM, ARVIND (Male)Provider Type: Physicians





NPI: 1073704581





CEB #: 1000035833

58


QASSEM, ZAHER (Male)Provider Type: Physicians





NPI: 1366551996





CEB #: 1000034118

ROY, BHARATI (Male)Provider Type: Physicians





NPI: 1366552556





CEB #: 1000034808

ROY, BHARATI (Male)Provider Type: Physicians





NPI: 1366552556





CEB #: 1000033717

THAPPA, VIVEK (Male)Provider Type: Physicians





NPI: 1295743383





CEB #: 1000034825

ZEATER, MOHAMED (Male)Provider Type: Physicians





NPI: 1285690958





CEB #: 1000033070

59


GENERAL SURGERY - IL - WINNEBAGOBENNETT, CINTHIA (Female)Provider Type: Nurse Practitioners





NPI: 1619396157





CEB #: 1000081292

PEDERSON, REBECCA (Male)Provider Type: Nurse Practitioners





NPI: 1255330635





CEB #: 1000032486

PINAWIN, MAXITA (Male)Provider Type: Nurse Practitioners





NPI: 1669416095





CEB #: 1000033571

ANCIL, PHILIP (Male)Provider Type: Physicians

Address: 1340 CHARLES ST - STE 100, ROCKFORD IL 61104Phone: 779-696-8700 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1295943884





CEB #: 1000103387


Address: 3535 N BELL SCHOOL RD , ROCKFORD IL 61114Phone: 779-696-9400 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1295943884





CEB #: 1000103395

60


APPAVU, SAMUEL K (Male)Provider Type: Physicians




Pri. Specialty: GENERAL SURGERY Sec. Specialty: SURGERY - TRAUMATIC

NPI: 1346243169


Pri. Language: ENGLISH Sec. Language: TAMIL



CEB #: 1000033178


Address: 2300 N ROCKTON AVE - STE 304, ROCKFORD IL 61103Phone: 815-964-3030 Network: AFFILIATED SURGEONS OF ROCKFORD LLC




NPI: 1346243169





CEB #: 1000079993






NPI: 1346243169





CEB #: 1000034622

BARTEAU, JEFFREY (Male)Provider Type: Physicians

Address: 5668 E STATE ST - STE 1000, ROCKFORD IL 61108Phone: 815-229-7580 Network: OSF MEDICAL GROUP

Pri. Hospital:



NPI: 1053344903





CEB #: 1000108426

BARTEAU, JEFFREY (Male)Provider Type: Physicians

Address: 5668 E STATE ST , ROCKFORD IL 61108Phone: 815-397-7212 Network: ROCKFORD SURGICAL SERVICES SC (TERMED 03/31/16)




NPI: 1053344903





CEB #: 1000059679

61


CABLE, DAVID (Male)Provider Type: Physicians

Address: 5668 E STATE ST - STE 1000, ROCKFORD IL 61108Phone: 815-397-7900 Network: ROCKFORD SURGICAL SERVICES SC (TERMED 03/31/16)



Pri. Specialty: GENERAL SURGERY Sec. Specialty: CARDIOTHORACIC SURGERY

NPI: 1033183728





CEB #: 1000059696

CABLE, DAVID (Male)Provider Type: Physicians

Address: 698 FEATHERSTONE RD , ROCKFORD IL 61107Phone: 8153983277 Network: OSF MEDICAL GROUP



Pri. Specialty: GENERAL SURGERY Sec. Specialty: CARDIOTHORACIC SURGERY

NPI: 1033183728





CEB #: 1000034066

CHURCH, FREDERICK W (Male)Provider Type: Physicians

Address: 7180 SPRING BROOK RD , ROCKFORD IL 61114Phone: 8159712299 Network: ROCKFORD HEALTH PHYSICIANS




NPI: 1871585034





CEB #: 1000034449

COWDEN, WILLIAM (Male)Provider Type: Physicians





NPI: 1033384904





CEB #: 1000033866

EDGCOMB, LESLIE (Female)Provider Type: Physicians


Pri. Hospital:


Pri. Specialty: GENERAL SURGERY Sec. Specialty: SURGERY - CARDIOVASCULAR

NPI: 1629014022





CEB #: 1000108436

62


EDGCOMB, LESLIE (Female)Provider Type: Physicians




Pri. Specialty: GENERAL SURGERY Sec. Specialty: SURGERY - CARDIOVASCULAR

NPI: 1629014022





CEB #: 1000059699

HAEBERLIN, JOHN (Male)Provider Type: Physicians





NPI: 1477650109





CEB #: 1000100342

HODGE, ROBERT (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1831298942





CEB #: 1000095863

HOFFMAN, ANDREW (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1104934389





CEB #: 1000095867

KELLER, MARY (Female)Provider Type: Physicians





NPI: 1275567703




Hrs: Mon: 08:00 - 17:00 Tue: 08:00 - 17:00 Wed: 08:00 - 17:00Accepts Medicaid: No

CEB #: 1000059704

63


KELLER, MARY (Female)Provider Type: Physicians


Pri. Hospital:



NPI: 1275567703





CEB #: 1000108443

MCCARTHY, MICHAEL (Male)Provider Type: Physicians

Address: 2350 N ROCKTON AVE - STE 510, ROCKFORD IL 61103Phone: 8159633426 Network: SURGICAL ASSOCIATES OF NORTHERN ILLINOIS LLC




NPI: 1851383061





CEB #: 1000059363

MCCARTHY, MICHAEL (Male)Provider Type: Physicians





NPI: 1851383061





CEB #: 1000034152

MICHELOTTI, MICHAEL (Male)Provider Type: Physicians





NPI: 1912991688




Hrs: Mon: 09:00 - 17:00 Tue: 09:00 - 17:00 Wed: 09:00 - 17:00Accepts Medicaid: Yes

CEB #: 1000059366

PICKERING, DACIA A (Female)Provider Type: Physicians


Pri. Hospital:



NPI: 1063686848





CEB #: 1000059728

64


RAUTER, MARK A (Male)Provider Type: Physicians





NPI: 1982606745





CEB #: 1000033636

ROBINSON, ELISHA (Male)Provider Type: Physicians





NPI: 1750584058





CEB #: 1000032870

SAYON, ABRAHAM (Male)Provider Type: Physicians

Address: 1340 CHARLES ST - STE 301B, ROCKFORD IL 61114Phone: 779-696-8700 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1104088285





CEB #: 1000093188

SCHAUER, JEFFREY (Male)Provider Type: Physicians





NPI: 1427054592





CEB #: 1000080002

SCHAUER, JEFFREY (Male)Provider Type: Physicians





NPI: 1427054592





CEB #: 1000033831

65


SCHNEIDER, DAVID (Male)Provider Type: Physicians





NPI: 1366602666





CEB #: 1000100345

WHITMAN, MARC (Male)Provider Type: Physicians




Pri. Specialty: GENERAL SURGERY Sec. Specialty: VASCULAR SURGERY

NPI: 1740214329





CEB #: 1000059739

WHITMAN, MARC (Male)Provider Type: Physicians


Pri. Hospital:


Pri. Specialty: GENERAL SURGERY Sec. Specialty: VASCULAR SURGERY

NPI: 1740214329





CEB #: 1000108466

WILCZAK, EMILY (Female)Provider Type: Physicians


Pri. Hospital:



NPI: 1386969400





CEB #: 1000095665

ZAPPIA, ANTHONY (Male)Provider Type: Physicians





NPI: 1184734402





CEB #: 1000033206

66


ZAPPIA, ANTHONY (Male)Provider Type: Physicians





NPI: 1184734402





CEB #: 1000035138

ZARNKE, MARK (Male)Provider Type: Physicians





NPI: 1295737948





CEB #: 1000034889

ZARNKE, MARK (Male)Provider Type: Physicians





NPI: 1295737948





CEB #: 1000059890






NPI: 1295943884





CEB #: 1000103377

67


ONCOLOGY - IL - WINNEBAGOBEGUM, HOSNE (Male)Provider Type: Physicians




Pri. Specialty: ONCOLOGY Sec. Specialty:

NPI: 1508942202





CEB #: 1000035485

68


PEDIATRICS - IL - WINNEBAGOBENTERS, JENNIFER (Female)Provider Type: Nurse Practitioners




Pri. Specialty: PEDIATRICS Sec. Specialty: NURSE PRACTITIONER

NPI: 1982004461





CEB #: 1000095273

BENTERS, JENNIFER (Female)Provider Type: Nurse Practitioners




Pri. Specialty: PEDIATRICS Sec. Specialty: NURSE PRACTITIONER

NPI: 1982004461





CEB #: 1000095269

69


SURGERY - CARDIOVASCULAR - IL - WINNEBAGOBOONE, KENDALL (Male)Provider Type: Physicians




Pri. Specialty: SURGERY - CARDIOVASCULAR Sec. Specialty:

NPI: 1861498909





CEB #: 1000079946

CZIPERLE, DAVID (Male)Provider Type: Physicians




Pri. Specialty: SURGERY - CARDIOVASCULAR Sec. Specialty: CARDIOTHORACIC SURGERY

NPI: 1295797900





CEB #: 1000033797

FOY, BRYAN (Male)Provider Type: Physicians

Address: 1401 E STATE ST - 1ST FL, ROCKFORD IL 61104Phone: 8153156102 Network: SWEDISHAMERICAN MEDICAL GROUP



Pri. Specialty: SURGERY - CARDIOVASCULAR Sec. Specialty: GENERAL SURGERY

NPI: 1972569754





CEB #: 1000033284

70


SURGERY - HEAD & NECK - IL - WINNEBAGOBRADLEY, STEPHEN (Male)Provider Type: Physicians




Pri. Specialty: SURGERY - HEAD & NECK Sec. Specialty: SURGICAL ONCOLOGY

NPI: 1164455028





CEB #: 1000059688

71


ORAL SURGERY - IL - WINNEBAGOBRUKSCH, MATTHEW (Male)Provider Type: Dentists




Pri. Specialty: ORAL SURGERY Sec. Specialty:

NPI: 1538394580





CEB #: 1000091792

72


PEDIATRIC SURGERY - IL - WINNEBAGOBUNTAIN, WILLIAM (Male)Provider Type: Physicians


Pri. Hospital:


Pri. Specialty: PEDIATRIC SURGERY Sec. Specialty: GENERAL SURGERY

NPI: 1700902608





CEB #: 1000093746

RETTIG, ARTHUR (Male)Provider Type: Physicians




Pri. Specialty: PEDIATRIC SURGERY Sec. Specialty:

NPI: 1376653568





CEB #: 1000034613

73


PEDIATRIC GASTROENTEROLOGY - IL - WINNEBAGOBURRESS, GLENDON (Male)Provider Type: Physicians




Pri. Specialty: PEDIATRIC GASTROENTEROLOGY Sec. Specialty:

NPI: 1639190200





CEB #: 1000032417

74


OBSTETRICS - IL - WINNEBAGOCOLOMBO, DAVID (Male)Provider Type: Physicians


Pri. Hospital:


Pri. Specialty: OBSTETRICS Sec. Specialty: MATERNAL & FETAL MEDICINE

NPI: 1164487716




Hrs:Sun: 09:00 - 17:0 Mon: 09:00 - 17:00 Tue: 09:00 - 17:00 Wed: 09:00 - 17:00 Thu: 09:00 - 17:00 Fri: 09:00 - 17:00Accepts Medicaid: Yes

CEB #: 1000091589

75


INTERVENTIONAL CARDIOLOGY - IL - WINNEBAGOCOOK, JEFFREY (Male)Provider Type: Physicians


Pri. Hospital:


Pri. Specialty: INTERVENTIONAL CARDIOLOGY Sec. Specialty: INTERNAL MEDICINE

NPI: 1952353518





CEB #: 1000096114

76


ALLERGY & IMMUNOLOGY - IL - WINNEBAGOCOOK, MARISHA (Female)Provider Type: Physicians




Pri. Specialty: ALLERGY & IMMUNOLOGY Sec. Specialty: INTERNAL MEDICINE

NPI: 1356487904





CEB #: 1000089412

FREY, CHARLES (Male)Provider Type: Physicians





NPI: 1356321244





CEB #: 1000095713

MOHIUDDIN, FATIMA (Male)Provider Type: Physicians

Address: 1253 N ALPINE RD , ROCKFORD IL 61107Phone: 8153917878 Network: SWEDISHAMERICAN MEDICAL GROUP



Pri. Specialty: ALLERGY & IMMUNOLOGY Sec. Specialty: PEDIATRIC ALLERGY & IMMUNOLOGY

NPI: 1578674834





CEB #: 1000034663

77


NEUROSURGERY - IL - WINNEBAGOCAIN, MAUREEN (Female)Provider Type: Nurse Practitioners




Pri. Specialty: NEUROSURGERY Sec. Specialty:

NPI: 1457416752





CEB #: 1000055594

ASNER, NESHER (Male)Provider Type: Physicians





NPI: 1750363651





CEB #: 1000033293

BRODERICK, RICHARD (Male)Provider Type: Physicians





NPI: 1285718833



Handicap Access: No


CEB #: 1000091744

CHU, GORDON (Male)Provider Type: Physicians





NPI: 1235310756





CEB #: 1000035781

DEVESHWAR, RAJEEV (Male)Provider Type: Physicians





NPI: 1144269432





CEB #: 1000035216

78


DEVESHWAR, RAJEEV (Male)Provider Type: Physicians





NPI: 1144269432





CEB #: 1000035988

FARHAT, HAMAD (Male)Provider Type: Physicians





NPI: 1861724064





CEB #: 1000090797

GRYFINSKI, MARTIN (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1588779763





CEB #: 1000095851

GRYFINSKI, MARTIN (Male)Provider Type: Physicians





NPI: 1588779763



Handicap Access: No


CEB #: 1000091897

VELIMIROVIC, BRATISLAV (Male)Provider Type: Physicians





NPI: 1477533081





CEB #: 1000035687

79


VELIMIROVIC, BRATISLAV (Male)Provider Type: Physicians





NPI: 1477533081





CEB #: 1000033423

80


INTERNAL MEDICINE - IL - WINNEBAGOCELNER, ANNE (Female)Provider Type: Nurse Practitioners




Pri. Specialty: INTERNAL MEDICINE Sec. Specialty: FAMILY PRACTICE

NPI: 1992057251





CEB #: 1000055616

ANSARI, MOHAMMED (Male)Provider Type: Physicians





NPI: 1649492620





CEB #: 1000033770

ARADHYULA, SWAPNA (Male)Provider Type: Physicians





NPI: 1659688588





CEB #: 1000035578

BARI, HUMAIRA (Female)Provider Type: Physicians





NPI: 1497845135





CEB #: 1000033125

DORSEY, JOHN (Male)Provider Type: Physicians





NPI: 1144330333





CEB #: 1000034861

81


EHTESHAM, RUBINA (Female)Provider Type: Physicians





NPI: 1962512152





CEB #: 1000033397

HERMAN, LUKE (Male)Provider Type: Physicians





NPI: 1457509150





CEB #: 1000033700

HERMAN, LUKE (Male)Provider Type: Physicians





NPI: 1457509150





CEB #: 1000032852

HYDER, AHTESHAM (Male)Provider Type: Physicians





NPI: 1740207505





CEB #: 1000034587

IVAN, AURELIAN (Male)Provider Type: Physicians





NPI: 1841467743





CEB #: 1000033748

82


MARINA, SHADI (Male)Provider Type: Physicians

Address: 1401 E STATE ST , ROCKFORD IL 61104Phone: 815-967-5476 Network: GEORGIA INPATIENT MEDICINE ASSOCIATES LLC




NPI: 1972764041



Handicap Access: No


CEB #: 1000087579

MCHUGH, HUGH (Male)Provider Type: Physicians





NPI: 1578673760





CEB #: 1000034306

NAEEM, SAIMA (Female)Provider Type: Physicians





NPI: 1164478616





CEB #: 1000035692

OLIN, ANNETTE (Female)Provider Type: Physicians





NPI: 1053323881





CEB #: 1000036052

PAK, CHONG H (Male)Provider Type: Physicians





NPI: 1003926296





CEB #: 1000035890

83


RASKIN, LEONID (Male)Provider Type: Physicians





NPI: 1558471748





CEB #: 1000034092

SALWAN, ASHIMA (Male)Provider Type: Physicians





NPI: 1871785923





CEB #: 1000034126

SIDDIQUI, NADEEM (Male)Provider Type: Physicians





NPI: 1447360631





CEB #: 1000034983

SYED, MALIHA (Female)Provider Type: Physicians





NPI: 1043230303





CEB #: 1000034077

WARD, CHRISTINE (Female)Provider Type: Physicians





NPI: 1982714176





CEB #: 1000035459

84


YUSAF, OMER (Male)Provider Type: Physicians





NPI: 1669585956





CEB #: 1000035558

85


PEDIATRIC CARDIOLOGY - IL - WINNEBAGOCHAN, DAVID (Male)Provider Type: Physicians

Address: 5701 STRATHMOOR DR - STE 1, ROCKFORD IL 61107Phone: 8152275600 Network: OSF MEDICAL GROUP

Pri. Hospital:



NPI: 1427057595





CEB #: 1000096075

FORAN, RONALD (Male)Provider Type: Physicians





NPI: 1710980396





CEB #: 1000095703

HUYOUNG, ALFRED (Male)Provider Type: Physicians





NPI: 1306849989





CEB #: 1000034425

KNEPP, MARC (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1568686277





CEB #: 1000095956

86


UROLOGY - IL - WINNEBAGOFUMO, MICHAEL (Male)Provider Type: Physicians




Pri. Specialty: UROLOGY Sec. Specialty:

NPI: 1528196656





CEB #: 1000035300

87


CARDIOTHORACIC SURGERY - IL - WINNEBAGOBONILLA, JUAN (Male)Provider Type: Physicians




Pri. Specialty: CARDIOTHORACIC SURGERY Sec. Specialty: GENERAL SURGERY

NPI: 1558327015





CEB #: 1000036186

CARTER, THOMAS (Male)Provider Type: Physicians





NPI: 1255364139





CEB #: 1000033640

CARTER, THOMAS (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1255364139





CEB #: 1000059691

CHENG, DAVID (Male)Provider Type: Physicians

Address: 1340 CHARLES ST - STE 301A, ROCKFORD IL 61104Phone: 779-696-8800 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1194781849





CEB #: 1000091795

GRAMM, JAMES (Male)Provider Type: Physicians





NPI: 1124084900





CEB #: 1000032412

88


HART, MICHAEL (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1558686709





CEB #: 1000108494

HART, MICHAEL (Male)Provider Type: Physicians

Address: 5668 E STATE ST , ROCKFORD IL 61108Phone: 815-397-7212 Network: ROCKFORD SURGICAL SERVICES SC (TERMED 03/31/16)

Pri. Hospital:



NPI: 1558686709





CEB #: 1000065164

KOLLA, SRINIVAS (Male)Provider Type: Physicians





NPI: 1235100397





CEB #: 1000058918

LEE, BRYAN (Male)Provider Type: Physicians





NPI: 1982628475





CEB #: 1000035508

MYERS, JOHN (Male)Provider Type: Physicians





NPI: 1174553523





CEB #: 1000058649

89


MYERS, JOHN (Male)Provider Type: Physicians





NPI: 1174553523





CEB #: 1000034833

TUCHEK, MICHAEL (Male)Provider Type: Physicians





NPI: 1598721250





CEB #: 1000034430

90


PHYSICAL THERAPY - IL - WINNEBAGOGULOTTA, BENJAMINProvider Type: Physical Therapists




Pri. Specialty: PHYSICAL THERAPY Sec. Specialty:

NPI: 1932327863





CEB #: 1000034778

91


PULMONOLOGY - IL - WINNEBAGOHANIF, NADEEM (Male)Provider Type: Physicians

Address: 5668 E STATE ST - STE B600, ROCKFORD IL 61108Phone: 8153977212 Network: NADEEM HANIF MD SC



Pri. Specialty: PULMONOLOGY Sec. Specialty:

NPI: 1972617181





CEB #: 1000033945

92


GERIATRICS - IL - WINNEBAGOHARTMAN, HEATHER (Male)Provider Type: Nurse Practitioners




Pri. Specialty: GERIATRICS Sec. Specialty: NURSE PRACTITIONER

NPI: 1598878464





CEB #: 1000033631

93


AUDIOLOGY - IL - WINNEBAGOAWENDER, CAROLYN (Male)Provider Type: Audiologists




Pri. Specialty: AUDIOLOGY Sec. Specialty:

NPI: 1942227905





CEB #: 1000035415

FILER, SARAH (Female)Provider Type: Audiologists

Address: 8038 MACINTOSH LN , ROCKFORD IL 61107Phone: 815-332-6800 Network: CENTER FOR SIGHT AND HEARING




NPI: 1467770941




Hrs: Wed: 08:00 - 16:30 Fri: 08:00 - 16:30Accepts Medicaid: Yes

CEB #: 1000034940

FILER, SARAH (Female)Provider Type: Audiologists





NPI: 1467770941





CEB #: 1000090747

HARTMAN, MELODY (Male)Provider Type: Audiologists





NPI: 1568483121





CEB #: 1000033120

HEMMER, MEGAN (Male)Provider Type: Audiologists





NPI: 1306192810





CEB #: 1000033280

94


POWELL, DAVID (Male)Provider Type: Audiologists

Address: 8038 MACINTOSH LN , ROCKFORD IL 61107Phone: 815-332-6800 Network: CENTER FOR SIGHT AND HEARING




NPI: 1386697597





CEB #: 1000034540

WORKMAN, CHRISTOPHER (Male)Provider Type: Audiologists





NPI: 1619957412





CEB #: 1000096148

95


HEMATOLOGY & MEDICAL ONCOLOGY - IL - WINNEBAGOEDWARDS, WILLIAM (Male)Provider Type: Physicians




Pri. Specialty: HEMATOLOGY & MEDICAL ONCOLOGY Sec. Specialty: INTERNAL MEDICINE

NPI: 1437140258





CEB #: 1000058443

EINHORN, HARVEY (Male)Provider Type: Physicians





NPI: 1689695108





CEB #: 1000058449

HASHIMI, MAY (Male)Provider Type: Physicians





NPI: 1154342293





CEB #: 1000032758

HOSKINS, KENT (Male)Provider Type: Physicians





NPI: 1255363529





CEB #: 1000035057

KARBASIAN ESFAHANI, MERAT (Male)Provider Type: Physicians





NPI: 1992740963





CEB #: 1000058473

96


KHAN, AJAZ (Male)Provider Type: Physicians





NPI: 1043484736





CEB #: 1000034970

KHAN, AJAZ (Male)Provider Type: Physicians





NPI: 1043484736





CEB #: 1000033391

KHATTAK, FAUZIA (Male)Provider Type: Physicians





NPI: 1265625354





CEB #: 1000058583

KORKMAZ, METE (Male)Provider Type: Physicians





NPI: 1902833999





CEB #: 1000034203

MARDINI, NAMEER (Male)Provider Type: Physicians




Pri. Specialty: HEMATOLOGY & MEDICAL ONCOLOGY Sec. Specialty: INTERNAL MEDICINE

NPI: 1821109448





CEB #: 1000033919

97


NORA, RICHARD (Male)Provider Type: Physicians





NPI: 1376570846





CEB #: 1000034864

NORA, RICHARD (Male)Provider Type: Physicians





NPI: 1376570846





CEB #: 1000034058

SCHULZ, WILLIAM (Male)Provider Type: Physicians





NPI: 1558382069





CEB #: 1000058731

SCHULZ, WILLIAM (Male)Provider Type: Physicians

Address: 209 9TH ST - STE 200, ROCKFORD IL 61104Phone: 8154894722 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1558382069





CEB #: 1000032831

SHAUKAT, ISMAEL (Male)Provider Type: Physicians





NPI: 1780814863





CEB #: 1000034846

98


SHIPP, SHARON (Male)Provider Type: Physicians





NPI: 1427079938





CEB #: 1000058753

SREENIVASAPPA, SHYLENDRA (Male)Provider Type: Physicians





NPI: 1972706604





CEB #: 1000033209

SREENIVASAPPA, SHYLENDRA (Male)Provider Type: Physicians

Address: 2400 N ROCKTON AVE , ROCKFORD IL 61103Phone: 815-971-5000 Network: OSF MEDICAL GROUP




NPI: 1972706604





CEB #: 1000034315

99


RHEUMATOLOGY - IL - WINNEBAGODIETZ, FREDERICK (Male)Provider Type: Physicians




Pri. Specialty: RHEUMATOLOGY Sec. Specialty: INTERNAL MEDICINE

NPI: 1235249426





CEB #: 1000035185

DIETZ, FREDERICK (Male)Provider Type: Physicians




Pri. Specialty: RHEUMATOLOGY Sec. Specialty: INTERNAL MEDICINE

NPI: 1235249426





CEB #: 1000033773

HOVIS, ROBIN (Male)Provider Type: Physicians





NPI: 1033229224





CEB #: 1000032607

HOVIS, ROBIN (Male)Provider Type: Physicians





NPI: 1033229224





CEB #: 1000035319

NIKA, AILDA (Male)Provider Type: Physicians





NPI: 1831316983





CEB #: 1000033316

100


NIKA, AILDA (Male)Provider Type: Physicians

Address: 7702 N ALPINE RD , ROCKFORD IL 61111Phone: 8159712000 Network: ROCKFORD HEALTH PHYSICIANS




NPI: 1831316983





CEB #: 1000033780

101


DERMATOLOGY - IL - WINNEBAGOHUDSON, ALBERT (Male)Provider Type: Physicians


Pri. Hospital:


Pri. Specialty: DERMATOLOGY Sec. Specialty:

NPI: 1053391334





CEB #: 1000095888

102


HOSPICE & PALLIATIVE MEDICINE - IL - WINNEBAGOGENTZ, CATHERINE (Male)Provider Type: Nurse Practitioners




Pri. Specialty: HOSPICE & PALLIATIVE MEDICINE Sec. Specialty:

NPI: 1205990801





CEB #: 1000058510

BARNHART, H TRENT (Male)Provider Type: Physicians




Pri. Specialty: HOSPICE & PALLIATIVE MEDICINE Sec. Specialty: FAMILY PRACTICE

NPI: 1477587921


Pri. Language: ENGLISH Sec. Language: CHINESE



CEB #: 1000095900

KALWEIT, JULIETTE (Female)Provider Type: Physicians





NPI: 1740216001


Pri. Language: ENGLISH Sec. Language: GERMAN



CEB #: 1000106735

KALWEIT, JULIETTE (Female)Provider Type: Physicians





NPI: 1740216001


Pri. Language: ENGLISH Sec. Language: GERMAN



CEB #: 1000032653

103


HOSPITALIST - IL - WINNEBAGOALI, AZRA (Female)Provider Type: Physicians


Pri. Hospital:


Pri. Specialty: HOSPITALIST Sec. Specialty: INTERNAL MEDICINE

NPI: 1700804028





CEB #: 1000095733

AMIN, ANIL (Male)Provider Type: Physicians





NPI: 1780604900





CEB #: 1000095803

BATH, HARNEET (Male)Provider Type: Physicians





NPI: 1679747760





CEB #: 1000095979

EGEKEZE, GILBERT (Male)Provider Type: Physicians





NPI: 1548361959





CEB #: 1000095808

KAMAL, BINOY (Male)Provider Type: Physicians





NPI: 1295805174





CEB #: 1000095926

104


MANOV, ZLATINA (Female)Provider Type: Physicians





NPI: 1477701639





CEB #: 1000095763

OANA, IULIA (Female)Provider Type: Physicians




Pri. Specialty: HOSPITALIST Sec. Specialty: INFECTIOUS DISEASE

NPI: 1306010756





CEB #: 1000092893

105


VASCULAR SURGERY - IL - WINNEBAGOWILLIAMS, KATHLEEN (Female)Provider Type: Nurse Practitioners




Pri. Specialty: VASCULAR SURGERY Sec. Specialty:

NPI: 1063418143





CEB #: 1000079996

KIKTA, MICHAEL (Male)Provider Type: Physicians





NPI: 1457357592





CEB #: 1000036034

KIKTA, MICHAEL (Male)Provider Type: Physicians





NPI: 1457357592





CEB #: 1000079964

KLAZURA, PAUL (Male)Provider Type: Physicians





NPI: 1407852551





CEB #: 1000058903

KLAZURA, PAUL (Male)Provider Type: Physicians





NPI: 1407852551





CEB #: 1000079956

106


MIJAL, SARA (Female)Provider Type: Physicians





NPI: 1720107261





CEB #: 1000100338

MIJAL, SARA (Female)Provider Type: Physicians





NPI: 1720107261




Hrs: Mon: 08:30 - 11:30 Thu: 13:00 - 16:30Accepts Medicaid: Yes

CEB #: 1000079999

107


PSYCHIATRY - IL - WINNEBAGORIEHLE, CRAIG (Male)Provider Type: Clinical Social Worker

Address: 1601 N UNIVERSITY DR , ROCKFORD IL 61107Phone: 8153872500 Network: PSYCHEALTH, LTD.

Pri. Hospital:



NPI: 1992031884





CEB #: 1000033630

RIEHLE, CRAIG (Male)Provider Type: Clinical Social Worker

Address: 3815 HARRISON AVE , ROCKFORD IL 61108Phone: 8153911000 Network: PSYCHEALTH, LTD.

Pri. Hospital:



NPI: 1992031884





CEB #: 1000034169

CATANIA, COLLEEN (Male)Provider Type: Other Behavior Health Professionals (Encounter only)


Pri. Hospital:



NPI: 1497031728





CEB #: 1000032482

RIZVI, ZAFFAR (Male)Provider Type: Physicians





NPI: 1730257056





CEB #: 1000043276

DSOUZA, ANTHONY (Male)Provider Type: Physicians





NPI: 1962502781





CEB #: 1000034675

108


GARCIA, RAYMOND (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1245217959





CEB #: 1000033879

GARCIA, RAYMOND (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1245217959





CEB #: 1000035625

IRFAN, SYED (Male)Provider Type: Physicians

Address: 2819 GLENWOOD , ROCKFORD IL 61101Phone: 8159712000 Network: ROCKFORD HEALTH PHYSICIANS




NPI: 1508895897





CEB #: 1000035523

JACONETTE, RICHARD (Male)Provider Type: Physicians

Address: 8616 NORTHERN AVE , ROCKFORD IL 61107Phone: 8153388003 Network: PSYCHEALTH, LTD.

Pri. Hospital:



NPI: 1578785432





CEB #: 1000034993

JAFRY, SHAHINA (Male)Provider Type: Physicians

Address: 526 W STATE ST , ROCKFORD IL 61101Phone: 8159689300 Network: PSYCHEALTH, LTD.

Pri. Hospital:



NPI: 1053383737





CEB #: 1000033751

109


KUNA, MICHAEL (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1750345872





CEB #: 1000033697

KUNA, MICHAEL (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1750345872





CEB #: 1000032594

MIDATHALA, GNANESWARA (Male)Provider Type: Physicians





NPI: 1750393237





CEB #: 1000034730






NPI: 1730257056





CEB #: 1000043278






NPI: 1730257056





CEB #: 1000043280

110


SRIVASTAVA, UMA (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1194815290





CEB #: 1000034834

VAID, KHATIJA (Female)Provider Type: Physicians





NPI: 1366641714





CEB #: 1000089385

111


SOCIAL WORKER - IL - WINNEBAGOCADMUS, LYNN (Male)Provider Type: Clinical Social Worker


Pri. Hospital:



NPI: 1356563332





CEB #: 1000034771

HOLM, R (Male)Provider Type: Clinical Social Worker

Address: 1200 W STATE ST , ROCKFORD IL 61102Phone: 815-490-1600 Network: PSYCHEALTH, LTD.

Pri. Hospital:



NPI: 1588876742





CEB #: 1000034222

LODGE, JOAN (Female)Provider Type: Clinical Social Worker


Pri. Hospital:



NPI: 1568559219





CEB #: 1000035218

LYONS, STEPHEN (Male)Provider Type: Clinical Social Worker


Pri. Hospital:



NPI: 1053683060





CEB #: 1000035336

STEPHAN, SUZANNE (Female)Provider Type: Clinical Social Worker


Pri. Hospital:



NPI: 1619246030





CEB #: 1000034014

112


DRENNEN, BETH (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1679899926





CEB #: 1000034089

113


OBSTETRICS & GYNECOLOGY - IL - WINNEBAGONALEWAY, KAREN (Female)Provider Type: Nurse Practitioners





NPI: 1457397341





CEB #: 1000042904

RHOADS, TEANA (Male)Provider Type: Nurse Practitioners

Address: 9721 N ALPINE RD , MACHESNEY PARK IL 61115Phone: 815-484-6300 Network: CORNERSTONE CLINIC LTD

Pri. Hospital:



NPI: 1215911334




Hrs:Sun: 08:00 - 17:0 Tue: 08:00 - 17:00 Wed: 08:00 - 17:00 Thu: 08:00 - 17:00 Fri: 08:00 - 17:00Accepts Medicaid: Yes

CEB #: 1000094146

ELLIOTT ZIPPE, CYNTHIA (Female)Provider Type: Nurse Practitioners





NPI: 1134148919





CEB #: 1000034327

GONZALEZ, MARIE (Female)Provider Type: Nurse Practitioners





NPI: 1992108666





CEB #: 1000091372

HULL, LOIS (Female)Provider Type: Nurse Practitioners





NPI: 1235227604





CEB #: 1000058521

114


HUNTLEY, ALICIA (Male)Provider Type: Nurse Practitioners





NPI: 1417068438





CEB #: 1000035051

KOCH, LAURA (Male)Provider Type: Nurse Practitioners





NPI: 1376714600





CEB #: 1000032806

MARTIN, LUCY (Male)Provider Type: Nurse Practitioners

Address: 7180 SPRINGBROOK RD - STE B, ROCKFORD IL 61114Phone: 8159712299 Network: ROCKFORD HEALTH PHYSICIANS




NPI: 1285606970





CEB #: 1000034284

MATHER, MARY (Male)Provider Type: Nurse Practitioners





NPI: 1033262522





CEB #: 1000033194

NALEWAY, KAREN (Female)Provider Type: Nurse Practitioners





NPI: 1457397341





CEB #: 1000042902

115


NALEWAY, KAREN (Female)Provider Type: Nurse Practitioners





NPI: 1457397341





CEB #: 1000042903

RYAN, ALTA (Male)Provider Type: Nurse Practitioners





NPI: 1639104359





CEB #: 1000034679

WEBERG, JILL (Female)Provider Type: Nurse Practitioners





NPI: 1801879663





CEB #: 1000058807






NPI: 1992797260





CEB #: 1000042822






NPI: 1124467253





CEB #: 1000094483

116







NPI: 1386950319





CEB #: 1000043210






NPI: 1598701088





CEB #: 1000042856






NPI: 1336370188





CEB #: 1000043249

HOLBROOK, JODI (Female)Provider Type: Physicians

Address: 9721 N ALPINE RD , MACHESNEY PARK IL 61115Phone: 815-484-6300 Network: CORNERSTONE CLINIC LTD




NPI: 1932138807





CEB #: 1000086672

ABDUL KHALEK, RANA (Male)Provider Type: Physicians





NPI: 1275768087





CEB #: 1000035193

117


ABDUL KHALEK, RANA (Male)Provider Type: Physicians





NPI: 1275768087





CEB #: 1000036020






NPI: 1992797260





CEB #: 1000042821


Address: 2780 MCFARLAND RD , ROCKFORD IL 61107Phone: 8156370000 Network: UIC COLLEGE OF MEDICINE AT ROCKFORD




NPI: 1992797260





CEB #: 1000036167






NPI: 1992797260





CEB #: 1000042816

ALQARA, FARES (Male)Provider Type: Physicians

Address: 6030 GARRETT LN , ROCKFORD IL 61107Phone: 8152261172 Network: OSF MEDICAL GROUP

Pri. Hospital:



NPI: 1124271978





CEB #: 1000095788

118







NPI: 1124467253





CEB #: 1000094480






NPI: 1124467253





CEB #: 1000094481

BADDOUR, BISHARA (Male)Provider Type: Physicians





NPI: 1093078388





CEB #: 1000034145

BHATTACHARYA, SUMOULINDRA (Male)Provider Type: Physicians





NPI: 1306906920





CEB #: 1000034784

BHATTACHARYA, SUMOULINDRA (Male)Provider Type: Physicians





NPI: 1306906920





CEB #: 1000033667

119







NPI: 1386950319





CEB #: 1000043204






NPI: 1386950319





CEB #: 1000107431






NPI: 1386950319





CEB #: 1000043207

CUNNINGHAM, WILLIAM (Male)Provider Type: Physicians





NPI: 1326153958





CEB #: 1000035795






NPI: 1326153958





CEB #: 1000033940

120







NPI: 1326153958





CEB #: 1000033991


Address: 1401 E STATE ST , ROCKFORD IL 61107Phone: 815-968-4400 Network: CRUSADER COMMUNITY HEALTH




NPI: 1326153958





CEB #: 1000090575


Address: 6861 VILLAGREEN VIEW , ROCKFORD IL 61107Phone: 8152821339 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1326153958





CEB #: 1000033903

DAVIS, LISA (Female)Provider Type: Physicians


Pri. Hospital:



NPI: 1861462616





CEB #: 1000090177

DURKEE, TIMOTHY (Male)Provider Type: Physicians





NPI: 1780682393





CEB #: 1000034285

121







NPI: 1780682393




Hrs: Wed: 13:00 - 16:00 Thu: 13:00 - 16:00Accepts Medicaid: Yes

CEB #: 1000035449






NPI: 1780682393





CEB #: 1000058953






NPI: 1780682393





CEB #: 1000034090

ENNEN, CHRISTOPHER (Male)Provider Type: Physicians





NPI: 1407836646





CEB #: 1000034523

GRANZEIER, GREGORY (Male)Provider Type: Physicians





NPI: 1134239320





CEB #: 1000035104

122







NPI: 1598701088





CEB #: 1000042855






NPI: 1598701088





CEB #: 1000091500






NPI: 1598701088





CEB #: 1000035326






NPI: 1598701088





CEB #: 1000042853

HIGGINS, PHILLIP (Male)Provider Type: Physicians





NPI: 1306956594





CEB #: 1000033236

123


HIGGINS, PHILLIP (Male)Provider Type: Physicians





NPI: 1306956594





CEB #: 1000035780

HOLDEN, JOHN (Male)Provider Type: Physicians





NPI: 1992856892





CEB #: 1000035287

HOLLMAN, CHARLES B (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1902908932





CEB #: 1000095879

JASPER, BRUCE (Male)Provider Type: Physicians





NPI: 1073511309





CEB #: 1000035907






NPI: 1073511309





CEB #: 1000058554

124







NPI: 1073511309





CEB #: 1000035285

MACAULAY, NICOLE (Male)Provider Type: Physicians





NPI: 1073799235





CEB #: 1000035348

MALONE, LISA (Female)Provider Type: Physicians





NPI: 1588647523





CEB #: 1000033606

MANAS, ARTURO (Male)Provider Type: Physicians

Address: 1415 E STATE ST - STE 800, ROCKFORD IL 61104Phone: 815-965-7117 Network: ARTURO S MANAS MD LTD




NPI: 1366452096





CEB #: 1000089053

MEYER, KARENMARIE (Female)Provider Type: Physicians





NPI: 1003811035





CEB #: 1000034274

125


MEYER, KARENMARIE (Female)Provider Type: Physicians





NPI: 1003811035





CEB #: 1000091503

MOORE, DAVID (Male)Provider Type: Physicians





NPI: 1538257969





CEB #: 1000058638






NPI: 1538257969





CEB #: 1000058641






NPI: 1538257969





CEB #: 1000033333






NPI: 1336370188





CEB #: 1000043251

126







NPI: 1336370188





CEB #: 1000043253

RANDEREE, RASHIDA (Female)Provider Type: Physicians


Pri. Hospital:



NPI: 1134329063





CEB #: 1000096274

SCHLEICHER, BETH ANN (Female)Provider Type: Physicians





NPI: 1356646673





CEB #: 1000032715

SCHLEICHER, BETH ANN (Female)Provider Type: Physicians





NPI: 1356646673





CEB #: 1000091494

SCHLEICHER, DAVID (Male)Provider Type: Physicians

Address: 1401 E STATE ST , ROCKFORD IL 61107Phone: 815-968-4400 Network: CRUSADER COMMUNITY HEALTH




NPI: 1790873016





CEB #: 1000090583

127



Address: 209 9TH ST - STE 200, ROCKFORD IL 61104Phone: 779-696-2750 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1790873016





CEB #: 1000100786






NPI: 1790873016





CEB #: 1000036067

SCOTT, SARAH (Female)Provider Type: Physicians


Pri. Hospital:



NPI: 1225247760





CEB #: 1000096301

SESSLAR, LEE (Female)Provider Type: Physicians





NPI: 1073511689





CEB #: 1000033275






NPI: 1073511689





CEB #: 1000035534

128







NPI: 1073511689





CEB #: 1000035581

SHAH, SUDHA (Male)Provider Type: Physicians





NPI: 1497753511





CEB #: 1000034153






NPI: 1497753511





CEB #: 1000032681






NPI: 1497753511





CEB #: 1000033196

STEPHENSON, C DAVID (Male)Provider Type: Physicians





NPI: 1538167895





CEB #: 1000035694

129







NPI: 1538167895





CEB #: 1000032732






NPI: 1538167895





CEB #: 1000036155

STEWART, JOSEPH (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1932204484





CEB #: 1000096324

TOUSSAINT, THOMAS (Male)Provider Type: Physicians





NPI: 1255625091





CEB #: 1000034877

TRAPP, JOHN (Male)Provider Type: Physicians





NPI: 1144248204





CEB #: 1000036048

130







NPI: 1144248204





CEB #: 1000036195






NPI: 1144248204





CEB #: 1000058794

WANG, JEANNIE (Male)Provider Type: Physicians





NPI: 1487714002





CEB #: 1000034296

WANG, JEANNIE (Male)Provider Type: Physicians





NPI: 1487714002





CEB #: 1000032869

GRANZEIER, GREGORY (Male)Provider Type: Physicians





NPI: 1134239320





CEB #: 1000034337

131







NPI: 1598701088





CEB #: 1000058849

132


OPHTHALMOLOGY - IL - WINNEBAGOBOONE, DIANE (Male)Provider Type: Physicians




Pri. Specialty: OPHTHALMOLOGY Sec. Specialty:

NPI: 1972613156





CEB #: 1000036079

KAPUR, RASHMI (Male)Provider Type: Physicians

Address: 2929 MCFARLAND AVE , ROCKFORD IL 61107Phone: 847-299-0700 Network: RETINA CONSULTANTS

Pri. Hospital:



NPI: 1962679498





CEB #: 1000066086

MATHEW, BENJAMIN (Male)Provider Type: Physicians





NPI: 1477781466





CEB #: 1000064653

133


MENTAL HEALTH COUNSELOR - IL - WINNEBAGOLINDBLADE, MELANIE (Male)Provider Type: Clinical Social Worker


Pri. Hospital:


Pri. Specialty: MENTAL HEALTH COUNSELOR Sec. Specialty:

NPI: 1598098378





CEB #: 1000035931

BARTOS, ELIZABETH (Male)Provider Type: Other Behavior Health Professionals (Encounter only)


Pri. Hospital:



NPI: 1427138312





CEB #: 1000035048

HOFFSTETTER, SUSAN (Female)Provider Type: Other Behavior Health Professionals (Encounter only)


Pri. Hospital:



NPI: 1275805624





CEB #: 1000033355

MOLL, KARI (Male)Provider Type: Other Behavior Health Professionals (Encounter only)


Pri. Hospital:



NPI: 1457681231





CEB #: 1000033082

TUTT, ROBERT (Male)Provider Type: Other Behavior Health Professionals (Encounter only)


Pri. Hospital:



NPI: 1821265588





CEB #: 1000033338

134


ENDOCRINOLOGY - IL - WINNEBAGOANSAR, SAMEER (Male)Provider Type: Physicians

Address: 5668 E STATE ST - STE 2000, ROCKFORD IL 61108Phone: 8153817790 Network: OSF MEDICAL GROUP




NPI: 1942485735





CEB #: 1000095812

ANSAR, SAMEER (Male)Provider Type: Physicians





NPI: 1942485735





CEB #: 1000095815

ERANKI, VIJAY (Male)Provider Type: Physicians

Address: 1253 N ALPINE RD , ROCKFORD IL 61107Phone: 779-696-9201 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1780859801





CEB #: 1000091884

HOVIS, JOHN (Male)Provider Type: Physicians





NPI: 1770693962





CEB #: 1000035744

NAGAVALLI, SRAVANTHI (Female)Provider Type: Physicians





NPI: 1861655375





CEB #: 1000058873

135


NASEER, ALIYA S (Male)Provider Type: Physicians





NPI: 1568572758





CEB #: 1000034427

PARVEEN, ZEENAT (Female)Provider Type: Physicians

Address: 5668 E STATE ST - STE 2000, ROCKFORD IL 61108Phone: 8153817790 Network: OSF MEDICAL GROUP




NPI: 1912099060





CEB #: 1000096212

PATURI, SHALINI (Male)Provider Type: Physicians





NPI: 1215191754





CEB #: 1000034230

136


NEUROLOGY - IL - WINNEBAGOROTH, TERRY R (Male)Provider Type: Physicians





NPI: 1215919816





CEB #: 1000043555

BACH, MALGORZATA (Male)Provider Type: Physicians





NPI: 1801852322





CEB #: 1000033260

BACH, MALGORZATA (Male)Provider Type: Physicians





NPI: 1801852322





CEB #: 1000032586

COLLINS, JOHN (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1750344404





CEB #: 1000096107

GARCIA, TRACEY (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1598920332





CEB #: 1000033766

137


KAUFMAN, MITCHELL (Male)Provider Type: Physicians





NPI: 1164536553





CEB #: 1000036104

KHAN, MOHSIN (Male)Provider Type: Physicians





NPI: 1174636013





CEB #: 1000034764

KHAN, MOHSIN (Male)Provider Type: Physicians





NPI: 1174636013





CEB #: 1000036040

ONEIL, JONATHAN (Male)Provider Type: Physicians




Pri. Specialty: NEUROLOGY Sec. Specialty: SLEEP MEDICINE

NPI: 1417163205





CEB #: 1000032657

ONEIL, JONATHAN (Male)Provider Type: Physicians




Pri. Specialty: NEUROLOGY Sec. Specialty: SLEEP MEDICINE

NPI: 1417163205





CEB #: 1000035281

138


OROZCO, DANIEL (Male)Provider Type: Physicians




Pri. Specialty: NEUROLOGY Sec. Specialty: VASCULAR NEUROLOGY

NPI: 1154329399





CEB #: 1000034020

RAJA, FAISAL (Male)Provider Type: Physicians





NPI: 1275644254





CEB #: 1000093574

ROTH, TERRY R (Male)Provider Type: Physicians





NPI: 1215919816





CEB #: 1000043557

ROTH, TERRY R (Male)Provider Type: Physicians





NPI: 1215919816





CEB #: 1000043558

SAJED, MOHAMMAD (Male)Provider Type: Physicians





NPI: 1396785127





CEB #: 1000034157

139


WALLERY, SHAWN (Male)Provider Type: Physicians





NPI: 1881851780





CEB #: 1000033776

140


SURGERY - TRAUMATIC - IL - WINNEBAGOPOULAKIDAS, STATHISProvider Type: Physicians


Pri. Hospital:


Pri. Specialty: SURGERY - TRAUMATIC Sec. Specialty:

NPI: 1508833344


Pri. Language: SPANISH Sec. Language: CANTONESE



CEB #: 1000108403

141


SURGERY - COLON & RECTAL - IL - WINNEBAGOMCCANSE, DONALD (Male)Provider Type: Physicians





NPI: 1568468619





CEB #: 1000033997

PRABHAKAR, LAWRENCE (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1467482828





CEB #: 1000059733

PRABHAKAR, LAWRENCE (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1467482828





CEB #: 1000108446

142


ENT/OTOLARYNGOLOGY - IL - WINNEBAGOCHHABRA, NIPUNProvider Type: Physicians




Pri. Specialty: ENT/OTOLARYNGOLOGY Sec. Specialty:

NPI: 1861687584





CEB #: 1000035222

FERGUSON, JONATHAN (Male)Provider Type: Physicians





NPI: 1669452934





CEB #: 1000033971

PROVENZA, MARGARET (Male)Provider Type: Physicians





NPI: 1457378283





CEB #: 1000035110

SEVERSON, JAMES (Male)Provider Type: Physicians





NPI: 1518912765





CEB #: 1000035546

ZAHURULLAH, FAZLUR (Male)Provider Type: Physicians





NPI: 1720068695





CEB #: 1000034259

143


ZAHURULLAH, FAZLUR (Male)Provider Type: Physicians





NPI: 1720068695





CEB #: 1000033143

144


SURGERY - CRITICAL CARE - IL - WINNEBAGOPYUN, EDWARD (Male)Provider Type: Physicians


Pri. Hospital:


Pri. Specialty: SURGERY - CRITICAL CARE Sec. Specialty: GENERAL SURGERY

NPI: 1386748473





CEB #: 1000096256

TAKEUCHI, TETSUYA (Male)Provider Type: Physicians


Pri. Hospital:


Pri. Specialty: SURGERY - CRITICAL CARE Sec. Specialty: GENERAL SURGERY

NPI: 1447550884





CEB #: 1000096377

145


SURGERY - MAXILLOFACIAL - IL - WINNEBAGORENTSCHLER, EDWARD (Male)Provider Type: Dentists




Pri. Specialty: SURGERY - MAXILLOFACIAL Sec. Specialty:

NPI: 1003977224





CEB #: 1000093174

146


PHYSICIAN ASSISTANT - IL - WINNEBAGORIVERA, SANTOS (Male)Provider Type: Physician Assistant


Pri. Hospital:



NPI: 1154335792





CEB #: 1000096277

147


INFECTIOUS DISEASE - IL - WINNEBAGOHOMANN, SCOTT (Male)Provider Type: Physicians





NPI: 1689674541





CEB #: 1000043405






NPI: 1629251715





CEB #: 1000043411






NPI: 1023278769





CEB #: 1000043422

HOMANN, SCOTT (Male)Provider Type: Physicians





NPI: 1689674541





CEB #: 1000043401

HOMANN, SCOTT (Male)Provider Type: Physicians





NPI: 1689674541





CEB #: 1000043404

148


SALEHEEN, QAMAR (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1194700567





CEB #: 1000096292






NPI: 1629251715





CEB #: 1000043415






NPI: 1629251715





CEB #: 1000043413

SUBRAMANIAN, KAVITHA (Female)Provider Type: Physicians





NPI: 1891817441





CEB #: 1000095658






NPI: 1023278769





CEB #: 1000043426

149







NPI: 1023278769





CEB #: 1000043424

150


VASCULAR NEUROLOGY - IL - WINNEBAGOSIMIONESCU, MONICA (Female)Provider Type: Physicians





NPI: 1184776403





CEB #: 1000043587

SIMIONESCU, MONICA (Female)Provider Type: Physicians


Pri. Hospital:



NPI: 1184776403





CEB #: 1000096319

SIMIONESCU, MONICA (Female)Provider Type: Physicians





NPI: 1184776403





CEB #: 1000043583

151


PAIN MANAGEMENT - IL - WINNEBAGOWOJCIECHOWSKI, TAMARA (Female)Provider Type: Nurse Practitioners





NPI: 1952359861





CEB #: 1000043532

WOJCIECHOWSKI, TAMARA (Female)Provider Type: Nurse Practitioners





NPI: 1952359861





CEB #: 1000043534

WOJCIECHOWSKI, TAMARA (Female)Provider Type: Nurse Practitioners





NPI: 1952359861





CEB #: 1000042945

GORELIK, MAXIM (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1548246101





CEB #: 1000093737

SINGH, ISHMEET (Male)Provider Type: Physicians





NPI: 1336306406





CEB #: 1000034502

152


CARDIAC ELECTROPHYSIOLOGY - IL - WINNEBAGOSHEIKH, ASAD (Male)Provider Type: Physicians




Pri. Specialty: CARDIAC ELECTROPHYSIOLOGY Sec. Specialty:

NPI: 1588759815





CEB #: 1000096341

SIRAJ, YASERProvider Type: Physicians




Pri. Specialty: CARDIAC ELECTROPHYSIOLOGY Sec. Specialty:

NPI: 1760497416





CEB #: 1000096246

153


CARDIOLOGY - IL - WINNEBAGOCHRISTENSON, KIM (Female)Provider Type: Nurse Practitioners





NPI: 1285076646





CEB #: 1000057034

JORDAL, DANIELLE (Male)Provider Type: Nurse Practitioners





NPI: 1639429855





CEB #: 1000032529

LARSON, LISA (Male)Provider Type: Nurse Practitioners





NPI: 1770643397





CEB #: 1000032429

MCGHEE, JULIE (Female)Provider Type: Nurse Practitioners




Pri. Specialty: CARDIOLOGY Sec. Specialty: ADVANCED PRACTICE NURSE

NPI: 1548322563





CEB #: 1000033384

RUSSELL, JOHN (Male)Provider Type: Nurse Practitioners

Address: 1340 CHARLES ST - STE 301A, ROCKFORD IL 61104Phone: 779-696-8800 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1104237130





CEB #: 1000093162

154


AHMED, MUBASHIR (Male)Provider Type: Physicians





NPI: 1366466377





CEB #: 1000055426

ATTA, TARA (Female)Provider Type: Physicians


Pri. Hospital:



NPI: 1639166374





CEB #: 1000095866

CACERES, ERBERT (Male)Provider Type: Physicians





NPI: 1508976788





CEB #: 1000033354

CACERES, ERBERT (Male)Provider Type: Physicians





NPI: 1508976788





CEB #: 1000034012

CASEY, CASH (Male)Provider Type: Physicians





NPI: 1518910306





CEB #: 1000034543

155


CHRISTENSEN, PAUL M (Male)Provider Type: Physicians





NPI: 1366467813





CEB #: 1000033426

DHANEKULA, LEELA (Female)Provider Type: Physicians




Pri. Specialty: CARDIOLOGY Sec. Specialty: CARDIAC ELECTROPHYSIOLOGY

NPI: 1801826938





CEB #: 1000095722

FAROKHI, FARHAD (Male)Provider Type: Physicians





NPI: 1639153216





CEB #: 1000095831

HAYES, RICHARD P (Male)Provider Type: Physicians





NPI: 1932177136





CEB #: 1000033116

HAYES, RICHARD P (Male)Provider Type: Physicians





NPI: 1932177136





CEB #: 1000034553

156


HELLMAN, JOEL (Male)Provider Type: Physicians





NPI: 1568402451





CEB #: 1000058892

HISER, MARK W (Male)Provider Type: Physicians





NPI: 1538184924





CEB #: 1000095998

ISAACSON, THOMAS (Male)Provider Type: Physicians





NPI: 1104884311





CEB #: 1000035028

KILARU, PRASAD (Male)Provider Type: Physicians





NPI: 1003910423





CEB #: 1000034865

KILARU, PRASAD (Male)Provider Type: Physicians





NPI: 1003910423





CEB #: 1000036021

157


KOTIS, ANDREW (Male)Provider Type: Physicians





NPI: 1982795894





CEB #: 1000033587

KURIEN, SHAUN (Male)Provider Type: Physicians





NPI: 1285608976





CEB #: 1000034099

MALLIK, RAJIV (Male)Provider Type: Physicians





NPI: 1285806935





CEB #: 1000064658

MAO, JUSTIN (Male)Provider Type: Physicians




Pri. Specialty: CARDIOLOGY Sec. Specialty: ELECTROPHYSIOLOGY

NPI: 1427052273





CEB #: 1000036128

MEJEVOI, NICOLAI (Male)Provider Type: Physicians





NPI: 1427369131





CEB #: 1000036004

158


MEJEVOI, NICOLAI (Male)Provider Type: Physicians





NPI: 1427369131





CEB #: 1000036107

MINOR, ROBERT (Male)Provider Type: Physicians





NPI: 1740209261





CEB #: 1000095940

MOHAMED, ELSAYED (Male)Provider Type: Physicians





NPI: 1841484813





CEB #: 1000033822

NARRA, LEELA (Female)Provider Type: Physicians





NPI: 1225001571





CEB #: 1000033689

NARRA, LEELA (Female)Provider Type: Physicians





NPI: 1225001571





CEB #: 1000035419

159


NOWAK, GREGORY (Male)Provider Type: Physicians





NPI: 1376516625





CEB #: 1000032814

NOWAK, GREGORY (Male)Provider Type: Physicians





NPI: 1376516625





CEB #: 1000036193

RABOR, DONALD (Male)Provider Type: Physicians





NPI: 1083687362





CEB #: 1000034144

RABOR, DONALD (Male)Provider Type: Physicians





NPI: 1083687362





CEB #: 1000034483

SARAON, TAJINDERPAL (Male)Provider Type: Physicians





NPI: 1235312331





CEB #: 1000034323

160


SHAH, GAURAV (Male)Provider Type: Physicians





NPI: 1780840207





CEB #: 1000055420

SILVA, EUGENE (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1235154659





CEB #: 1000096356

SKOWRONSKI, JAN (Male)Provider Type: Physicians





NPI: 1790710283





CEB #: 1000095650

SMITH, JEFFREY (Male)Provider Type: Physicians





NPI: 1346200938





CEB #: 1000033850

SMITH, JEFFREY (Male)Provider Type: Physicians





NPI: 1346200938





CEB #: 1000032646

161


TELFER, EDWARD (Male)Provider Type: Physicians





NPI: 1700805249





CEB #: 1000095667

VALAITIS, JOSEPH (Male)Provider Type: Physicians





NPI: 1437269628





CEB #: 1000035332

WANG, XU (Male)Provider Type: Physicians





NPI: 1558577460





CEB #: 1000095647

ZAVERDAS, GEORGE (Male)Provider Type: Physicians


Pri. Hospital: SAINT ANTHONY HOSPITAL



NPI: 1295798742





CEB #: 1000096069

162


RADIATION ONCOLOGY - IL - WINNEBAGOANDREWS, SAMUEL (Male)Provider Type: Physicians





NPI: 1851508337





CEB #: 1000034250

BRYAN, GEORGE (Male)Provider Type: Physicians





NPI: 1447287495





CEB #: 1000034108

DUNN, WILLIAM (Male)Provider Type: Physicians





NPI: 1669447504





CEB #: 1000090951

IFTEKHAR, AHMAD (Male)Provider Type: Physicians





NPI: 1164641791





CEB #: 1000036157

KOZAK, KEVIN (Male)Provider Type: Physicians





NPI: 1124219241





CEB #: 1000090807

163


SMOROWSKI, KAREN (Male)Provider Type: Physicians





NPI: 1427044833





CEB #: 1000033806

STAPLEFORD, LIZA (Female)Provider Type: Physicians





NPI: 1235316720





CEB #: 1000090828

164


SURGICAL ONCOLOGY - IL - WINNEBAGOSONI, MEHUL (Male)Provider Type: Physicians




Pri. Specialty: SURGICAL ONCOLOGY Sec. Specialty: GENERAL SURGERY

NPI: 1265609739





CEB #: 1000059736

SONI, MEHUL (Male)Provider Type: Physicians


Pri. Hospital:


Pri. Specialty: SURGICAL ONCOLOGY Sec. Specialty: GENERAL SURGERY

NPI: 1265609739





CEB #: 1000108456

165


GASTROENTEROLOGY - IL - WINNEBAGOSTANDFIELD, SHEILA (Female)Provider Type: Nurse Practitioners




Pri. Specialty: GASTROENTEROLOGY Sec. Specialty:

NPI: 1033537352





CEB #: 1000081304

166


ORTHOPEDIC SURGERY - IL - WINNEBAGOANTON, OSCAR (Male)Provider Type: Physicians





NPI: 1700089729





CEB #: 1000035128

BEAR, BRIAN (Male)Provider Type: Physicians





NPI: 1164535837





CEB #: 1000035012

DANAHER, THOMAS (Male)Provider Type: Physicians





NPI: 1114994845





CEB #: 1000035542

DANNENMAIER, WILLIAM (Male)Provider Type: Physicians





NPI: 1619944337





CEB #: 1000032585

EARHART, JEFFREY (Male)Provider Type: Physicians





NPI: 1124284898





CEB #: 1000058886

167


FERRY, SCOTT (Male)Provider Type: Physicians

Address: 324 roxbury rd , ROCKFORD IL 61107Phone: 815-398-9491 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1417178385





CEB #: 1000058844

FERRY, SCOTT (Male)Provider Type: Physicians

Address: 324 roxbury rd , ROCKFORD IL 61107Phone: 815-398-9491 Network: ROCKFORD ORTHOPEDIC ASSOCIATES, LTD

Pri. Hospital:



NPI: 1417178385





CEB #: 1000107842

FISCHER, ANDREAS (Male)Provider Type: Physicians





NPI: 1235139452





CEB #: 1000095654

FOSTER, BRIAN (Male)Provider Type: Physicians





NPI: 1619133139





CEB #: 1000091892

FOSTER, BRIAN (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1619133139





CEB #: 1000043736

168


HASTINGS, MARK (Male)Provider Type: Physicians





NPI: 1477553659





CEB #: 1000095973

KORCEK, KENNETH (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1396850657





CEB #: 1000107852

KORCEK, KENNETH (Male)Provider Type: Physicians





NPI: 1396850657





CEB #: 1000058593

MILOS, STEVEN (Male)Provider Type: Physicians





NPI: 1093839300





CEB #: 1000034111

NYQUIST, SCOTT (Male)Provider Type: Physicians





NPI: 1215904958





CEB #: 1000034563

169


SCHWARTZ, EDRIC (Male)Provider Type: Physicians





NPI: 1134326770





CEB #: 1000033535

SCHWARTZ, EDRIC (Male)Provider Type: Physicians





NPI: 1134326770





CEB #: 1000058737

VAN THIEL, GEOFFREY (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1316103971





CEB #: 1000043733

ZUSSMAN, MARC (Male)Provider Type: Physicians

Address: 5875 E RIVERSIDE BLVD , ROCKFORD IL 61114Phone: 815-398-9491 Network: ROCKFORD ORTHOPEDIC ASSOCIATES, LTD

Pri. Hospital:



NPI: 1255327326





CEB #: 1000107804



Pri. Hospital:



NPI: 1255327326





CEB #: 1000107801

170







NPI: 1255327326





CEB #: 1000034690






NPI: 1255327326





CEB #: 1000034690

171


PHYSICAL MEDICINE & REHABILITATION - IL - WINNEBAGOVO, ANDREW (Male)Provider Type: Physicians




Pri. Specialty: PHYSICAL MEDICINE & REHABILITATION Sec. Specialty:

NPI: 1730297763





CEB #: 1000034963

172


PLASTIC & RECONSTRUCTIVE SURGERY - IL - WINNEBAGOHAGARTY, SARAH (Female)Provider Type: Physicians




Pri. Specialty: PLASTIC & RECONSTRUCTIVE SURGERY Sec. Specialty:

NPI: 1790894897





CEB #: 1000095861

KIM, LIZA (Male)Provider Type: Physicians





NPI: 1952515322





CEB #: 1000033647

PRYOR, LANDON (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1831306968





CEB #: 1000058879

RODRIGUEZ, PEDRO (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1881889194





CEB #: 1000096283

WASHAK, RONALD (Male)Provider Type: Physicians





NPI: 1265548945





CEB #: 1000034807

173


WEISKOPF, JEROME (Male)Provider Type: Physicians





NPI: 1992814628





CEB #: 1000093226

174


- IL - WINNEBAGOWILSON, MICHAEL (Male)Provider Type: Physicians




Pri. Specialty: Sec. Specialty:

NPI: 1083600027





CEB #: 1000093232

175


FAMILY PRACTICE - IL - WINNEBAGOBRICK, GAIL (Female)Provider Type: Nurse Practitioners


Pri. Hospital:



NPI: 1679724561





CEB #: 1000090222

BURKART, COLLEEN (Female)Provider Type: Nurse Practitioners





NPI: 1073785101





CEB #: 1000032461






NPI: 1669555199





CEB #: 1000042862

MCGRATH, CYNTHIA (Female)Provider Type: Nurse Practitioners





NPI: 1568452555





CEB #: 1000095896

MCGRATH, CYNTHIA (Female)Provider Type: Nurse Practitioners





NPI: 1568452555





CEB #: 1000034407

176


MEADE, KATHLEEN (Female)Provider Type: Nurse Practitioners





NPI: 1447223789





CEB #: 1000095922

VELAZQUEZ, VIRGINIA (Female)Provider Type: Nurse Practitioners





NPI: 1609952670





CEB #: 1000095685

BEHLING, REBECCA (Female)Provider Type: Nurse Practitioners





NPI: 1508060518





CEB #: 1000034063

BRICK, GAIL (Female)Provider Type: Nurse Practitioners


Pri. Hospital:



NPI: 1679724561





CEB #: 1000035492

COOK, ERICA (Female)Provider Type: Nurse Practitioners





NPI: 1205106341



Handicap Access: No


CEB #: 1000091859

177


DAGEFOERDE, NANCY (Female)Provider Type: Nurse Practitioners


Pri. Hospital:



NPI: 1073532511





CEB #: 1000096441

HESS, MEGHAN (Male)Provider Type: Nurse Practitioners





NPI: 1770854085





CEB #: 1000035106






NPI: 1669555199





CEB #: 1000042863






NPI: 1669555199





CEB #: 1000042864






NPI: 1669555199





CEB #: 1000107623

178


JACK, CYNTHIA (Female)Provider Type: Nurse Practitioners





NPI: 1710222807





CEB #: 1000035601

KERTZ, NANCY (Female)Provider Type: Nurse Practitioners





NPI: 1063424836





CEB #: 1000033348

KRAUSE, CHRISTINE (Female)Provider Type: Nurse Practitioners


Pri. Hospital:



NPI: 1801886890





CEB #: 1000095950

LIZER, SHANNON (Female)Provider Type: Nurse Practitioners





NPI: 1023100781





CEB #: 1000036011

LOBDELL, TAMI (Male)Provider Type: Nurse Practitioners

Address: 1340 CHARLES ST - STE 301C, ROCKFORD IL 61104Phone: 779-696-8799 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1619303542





CEB #: 1000091929

179


LOGLI, KELLY (Female)Provider Type: Nurse Practitioners




Pri. Specialty: FAMILY PRACTICE Sec. Specialty: ENDOCRINOLOGY

NPI: 1730404419





CEB #: 1000058901

NICE, MICHELLE (Female)Provider Type: Nurse Practitioners





NPI: 1457540379





CEB #: 1000032630

ROSENBERGER, KELLY (Female)Provider Type: Nurse Practitioners





NPI: 1790760080





CEB #: 1000034953

SAVAGE, CHRISTINE (Female)Provider Type: Nurse Practitioners


Pri. Hospital:



NPI: 1528114956





CEB #: 1000096307

VELAZQUEZ, VIRGINIA (Female)Provider Type: Nurse Practitioners





NPI: 1609952670





CEB #: 1000095676

180


WOLF, KATHERINE (Female)Provider Type: Nurse Practitioners





NPI: 1386992196





CEB #: 1000032509

BRICK, GAIL (Female)Provider Type: Nurse Practitioners


Pri. Hospital:



NPI: 1679724561





CEB #: 1000090260

HUBER, AMANDA (Female)Provider Type: Nurse Practitioners





NPI: 1841600715





CEB #: 1000091914

KRAUSE, CHRISTINE (Female)Provider Type: Nurse Practitioners

Address: 4682 E ROCKTON RD - STE 102, ROSCOE IL 61073Phone: 8156241300 Network: OSF MEDICAL GROUP

Pri. Hospital:



NPI: 1801886890





CEB #: 1000095947

FINNEGAN, DAVID (Male)Provider Type: Physician Assistant





NPI: 1477579563





CEB #: 1000034704

181


DEMARAIS, DEAN (Male)Provider Type: Physician Assistant





NPI: 1932166600





CEB #: 1000034520

DOHERTY, ANDREW (Male)Provider Type: Physician Assistant





NPI: 1962716456





CEB #: 1000033315

GILLOOLEY, LEESA (Female)Provider Type: Physician Assistant





NPI: 1154567964





CEB #: 1000095791

BLYTHE, HEATHER (Female)Provider Type: Physicians


Pri. Hospital:



NPI: 1417267832





CEB #: 1000096012

DORONILA HUGHES, KATERINA (Female)Provider Type: Physicians





NPI: 1942304456





CEB #: 1000032609

182


ENGLUND, KAREN (Female)Provider Type: Physicians





NPI: 1407872591





CEB #: 1000034920



Pri. Hospital:



NPI: 1730316043





CEB #: 1000040050



Pri. Hospital:



NPI: 1427368935





CEB #: 1000081046

KALEEMUDDIN, MOHAMMED (Male)Provider Type: Physicians





NPI: 1437119450





CEB #: 1000095917

KHAN, ASRA (Female)Provider Type: Physicians





NPI: 1023018322





CEB #: 1000095944

183


LUCIETTO SIERADZKI, THERESE (Male)Provider Type: Physicians





NPI: 1699708636





CEB #: 1000095736

MOHIUDDIN, SYED (Male)Provider Type: Physicians





NPI: 1144216243





CEB #: 1000035860



Pri. Hospital:



NPI: 1912136896





CEB #: 1000090370



Pri. Hospital:



NPI: 1447240445





CEB #: 1000096193

QADRI, MUNEEB (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1972815033





CEB #: 1000096265

184




Pri. Hospital:



NPI: 1982694980





CEB #: 1000096328






NPI: 1275829178





CEB #: 1000081090



Pri. Hospital:



NPI: 1659358703





CEB #: 1000096374






NPI: 1508895780





CEB #: 1000096381






NPI: 1184856155





CEB #: 1000032620

185


WINTERBAUER, SUSAN C (Female)Provider Type: Physicians


Pri. Hospital: OSF ST ANTHONY MED CTR



NPI: 1073816013





CEB #: 1000034698

AL SARAF, ABBAS (Male)Provider Type: Physicians





NPI: 1245221134





CEB #: 1000033323

BARIS, AL (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1821029091





CEB #: 1000033319

BRANSON, WAYNE (Male)Provider Type: Physicians





NPI: 1972749158





CEB #: 1000034215

CLOR, MONA (Female)Provider Type: Physicians





NPI: 1932182003





CEB #: 1000035002

186


ECKBURG, JOSEPH (Male)Provider Type: Physicians





NPI: 1154492312





CEB #: 1000034174



Pri. Hospital:



NPI: 1730316043





CEB #: 1000040053



Pri. Hospital:



NPI: 1730316043





CEB #: 1000040060

HITT, ROCKTON (Male)Provider Type: Physicians





NPI: 1225108947





CEB #: 1000033552

HOLLOWAY, LIANNE (Male)Provider Type: Physicians





NPI: 1619000932





CEB #: 1000034221

187


LIN, BILLIE (Female)Provider Type: Physicians





NPI: 1780786301





CEB #: 1000058825

MUELLER, JOHN (Male)Provider Type: Physicians





NPI: 1952335333





CEB #: 1000032846

NICOLOSI, FRANCIS (Male)Provider Type: Physicians


Pri. Hospital: ROCKFORD MEM HOSP



NPI: 1477663664





CEB #: 1000032713






NPI: 1215946892





CEB #: 1000033819






NPI: 1619910635





CEB #: 1000033400

188


SCHOLCOFF, EDUARDO (Male)Provider Type: Physicians


Pri. Hospital: SWEDISH COVENANT HOSPITAL



NPI: 1669457214





CEB #: 1000034585

SCHOLCOFF, EDUARDO (Male)Provider Type: Physicians

Address: 2473 MCFARLAND RD , ROCKFORD IL 61107Phone: 779-696-9202 Network: SWEDISHAMERICAN MEDICAL GROUP




NPI: 1669457214





CEB #: 1000093236






NPI: 1275829178





CEB #: 1000081032

SHARKEY, CARRIE (Female)Provider Type: Physicians


Pri. Hospital:



NPI: 1295725323





CEB #: 1000035716

SIMMONS, MARY (Female)Provider Type: Physicians





NPI: 1457373946





CEB #: 1000034102

189




Pri. Hospital:



NPI: 1659358703





CEB #: 1000096371

SYED, JAFRI H (Male)Provider Type: Physicians





NPI: 1942226949



Handicap Access: No


CEB #: 1000087563

WINTERBAUER, SUSAN C (Female)Provider Type: Physicians





NPI: 1073816013





CEB #: 1000035061

LIN, BILLIE (Female)Provider Type: Physicians





NPI: 1780786301





CEB #: 1000035568






NPI: 1215946892





CEB #: 1000035660

190




Pri. Hospital:



NPI: 1447240445





CEB #: 1000096199



Pri. Hospital:



NPI: 1982694980





CEB #: 1000096331






NPI: 1659358703





CEB #: 1000034148






NPI: 1124064001





CEB #: 1000034457






NPI: 1821283565





CEB #: 1000033100

191


NEPHROLOGY - IL - WINNEBAGOAHMAD, MASHOOD (Male)Provider Type: Physicians

Address: 612 ROXBURY RD , ROCKFORD IL 61107Phone: 815-227-8300 Network: RNA OF ROCKFORD LLC

Pri. Hospital:



NPI: 1043232846





CEB #: 1000092592

CHARBA, DEANE (Female)Provider Type: Physicians


Pri. Hospital:



NPI: 1245281492





CEB #: 1000092597

MAYNARD, JOHN (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1730180878





CEB #: 1000092604

MURDAKES, CHARLENE (Female)Provider Type: Physicians


Pri. Hospital:



NPI: 1992961593





CEB #: 1000092612

NIEMIEC, JOANNA (Female)Provider Type: Physicians


Pri. Hospital:



NPI: 1821016791





CEB #: 1000092616

192


PAVITHRAN, BINDU (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1548210677





CEB #: 1000092638

ROBERTSON, MICHAEL (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1093717027





CEB #: 1000092623

SANKARAN, KRISHNA (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1558353631





CEB #: 1000092643

STIM, JAMES (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1104827427





CEB #: 1000092653

SWEENEY, CHARLES (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1063414944





CEB #: 1000092661

193


WRIGHT, DAVID L (Male)Provider Type: Physicians


Pri. Hospital:



NPI: 1033131776





CEB #: 1000092576

194


NURSE PRACTITIONER - IL - WINNEBAGOEATOCK, CAROLE (Female)Provider Type: Nurse Practitioners

Address: 4682 E ROCKTON RD - STE 102, ROSCOE IL 61073Phone: 8156241300 Network: OSF MEDICAL GROUP

Pri. Hospital:



NPI: 1588964712





CEB #: 1000095804

195


PODIATRY - IL - WINNEBAGOBUSH, WILLIAM (Male)Provider Type: Podiatrists


Pri. Hospital:



NPI: 1124131891





CEB #: 1000059212

HOFFMAN, HEATH (Male)Provider Type: Podiatrists





NPI: 1528231354





CEB #: 1000034246

NIELSEN, JOHN (Male)Provider Type: Podiatrists





NPI: 1821186263





CEB #: 1000034237

NOREM, NATHAN (Male)Provider Type: Podiatrists





NPI: 1801025473





CEB #: 1000034116

ROSHAN, SYEDA (Male)Provider Type: Podiatrists





NPI: 1770915589





CEB #: 1000093112

196


CHIROPRACTOR - IL - WINNEBAGOFREEDLUND, HEATHER (Female)Provider Type: Chiropractors

Address: 119 S BENTON ST , WINNEBAGO IL 61088Phone: 815-335-1381 Network: FREEDLUND FAMILY CHIROPRACTIC LTD

Pri. Hospital:



NPI: 1861417073





CEB #: 1000089046

197


Provider Directory

Rockford‐area Hospitals

IL - MCHENRYNORTHERN ILLINOIS MEDICAL CTRProvider Type: General Hospitals

Address: 4201 MEDICAL CENTER DR , MCHENRY IL 60050Phone: Network: NORTHERN ILLINOIS MEDICAL CTR

Pri. Hospital:


Pri. Specialty: GENERAL INPATIENT SERVICES Sec. Specialty:

NPI: 1982611281



Handicap Access: YesAccepts Medicaid: Yes

CEB #: 1000057431

MEMORIAL MEDICAL CENTERProvider Type: General Hospitals

Address: 3701 DOTY RD , WOODSTOCK IL 60098Phone: 815-338-2500 Network: MEMORIAL MEDICAL CENTER

Pri. Hospital:


Pri. Specialty: GENERAL INPATIENT SERVICES Sec. Specialty: INPATIENT PSYCHIATRIC SERVICES

NPI: 1730194259




CEB #: 1000065581

MEMORIAL MEDICAL CENTERProvider Type: General Hospitals

Address: 527 W SOUTH ST , woodstock IL 60098Phone: 800-765-9999 Network: MEMORIAL MEDICAL CENTER

Pri. Hospital:


Pri. Specialty: INPATIENT PSYCHIATRIC SERVICES Sec. Specialty:

NPI: 1427065499




CEB #: 1000065583

1

Hospitals - CCAI, NFP ( Rockford )Member Services: 1-855-275-2781 8 Provider(s) TTY: 711

IL - WINNEBAGOROCKFORD MEMORIAL HOSPITALProvider Type: General Hospitals

Address: 2400 N ROCKTON AVE , ROCKFORD IL 61103Phone: 815-971-5000 Network: ROCKFORD MEMORIAL HOSPITAL

Pri. Hospital:



NPI: 1629118609




CEB #: 1000039864

ST ANTHONY MEDICAL CENTERProvider Type: General Hospitals

Address: 5666 E STATE ST , ROCKFORD IL 61108Phone: 815-226-2000 Network: ST ANTHONY MEDICAL CENTER

Pri. Hospital:


Pri. Specialty: GENERAL INPATIENT SERVICES Sec. Specialty:

NPI: 1790739977




CEB #: 1000054954

SWEDISHAMERICAN HOSPITALProvider Type: General Hospitals

Address: 1401 E STATE ST , ROCKFORD IL 61104Phone: 815-968-4400 Network: SWEDISHAMERICAN HOSPITAL

Pri. Hospital:



NPI: 1760542732



Handicap Access: NoAccepts Medicaid: Yes

CEB #: 1000057489

RAHMAN, AZIZUR (Male)Provider Type: Physicians

Address: 3865 N MULFORD RD , ROCKFORD IL 61114Phone: 815-399-2190 Network: NON-PAR NETWORK

Pri. Hospital:



NPI: 1346212693




CEB #: 1000108750

VAN MATRE HEALTHSOUTH REHABILITATION HOSPITALProvider Type: Rehabilitation Hospitals

Address: 950 S MULFORD RD , ROCKFORD IL 61108Phone: 815-381-8500 Network: VAN MATRE HEALTHSOUTH REHABILITATION HOSPITAL

Pri. Hospital:


Pri. Specialty: INPATIENT PHYSICAL REHABILITATION SERVICES Sec. Specialty:

NPI: 1215901970



Handicap Access: NoAccepts Medicaid: Yes

CEB #: 1000015345

2


Provider Directory

Rockford‐area

Behavioral Health

1

Behavioral Health - CCAI, NFP ( Rockford )Member Services: 1-855-275-2781 0 Provider(s) TTY: 711


Provider Directory

Rockford‐area Ancillary

IL - BOONEPARK PLACE OF BELVIDEREProvider Type: Nursing Facilities

Address: 1701 W 5TH AVE , BELVIDERE IL 61008Phone: 847-311-2675 Network: PARK PLACE OF BELVIDERE

Pri. Hospital:


Pri. Specialty: SKILLED NURSING FACILITY Sec. Specialty: PHYSICAL THERAPY

NPI: 1801233846





CEB #: 1000066479

HERITAGE WOODS OF BELVIDEREProvider Type: Supportive Living Facility

Address: 4730 SQUAW PRAIRIE RD , BELVIDERE IL 61008Phone: 815-544-9495 Network: HERITAGE WOODS OF BELVIDERE

Pri. Hospital:


Pri. Specialty: SUPPORTIVE LIVING FACILITY Sec. Specialty:

NPI: 1144652363





CEB #: 1000085718

1

Ancillary - CCAI, NFP ( Rockford )50 Provider(s)

IL - MCHENRYHANGER PROSTHETICS ORTHOTICSProvider Type: Durable Medical Equipment/Supply

Address: 620 S ROUTE 31 - STE 7, MCHENRY IL 60050Phone: 815-344-3070 Network: HANGER CLINIC

Pri. Hospital:


Pri. Specialty: DME Sec. Specialty:

NPI: 1891860664





CEB #: 1000087019

NORTHERN ILLINOIS MEDICAL CTRProvider Type: Durable Medical Equipment/Supply

Address: 213 FRONT ST - STE 2, MCHENRY IL 60050Phone: 815-759-4444 Network: CENTEGRA PHYSICIAN CARE

Pri. Hospital:



NPI: 1780989905





CEB #: 1000085520

CRYSTAL SPRINGS DIALYSISProvider Type: General Hospitals

Address: 720 COG CIRCLE , CRYSTAL LAKE IL 60014Phone: 815-459-4945 Network: DAVITA HEALTHCARE PARTNERS INC

Pri. Hospital:


Pri. Specialty: DIALYSIS Sec. Specialty:

NPI: 1073826392





CEB #: 1000086150

FMC OF MCHENRYProvider Type: General Hospitals

Address: 4312 W ELM ST , MCHENRY IL 60050Phone: 815-363-7254 Network: FRESENIUS MEDICAL CARE

Pri. Hospital:



NPI: 1255421756





CEB #: 1000086570

CENTEGRA HOME HEALTH CAREProvider Type: Home Health Agencies - In Home

Address: 213 N FRONT ST - STE 2, MCHENRY IL 60050Phone: 877-236-8347 Network: CENTEGRA HEALTH CARE SYSTEM

Pri. Hospital:


Pri. Specialty: HOME HEALTH Sec. Specialty: HOME HEALTH AIDE

NPI: 1447298450





CEB #: 1000085523

2


1ST FAMILY HOME HEALTHCARE INCProvider Type: Home Health Agencies - In Home

Address: 666 RUSSEL CT - STE 308, WOODSTOCK IL 60098Phone: 815-337-4240 Network: 1ST FAMILY HOME HEALTHCARE INC

Pri. Hospital:


Pri. Specialty: SKILLED NURSING Sec. Specialty: SPEECH PATHOLOGY

NPI: 1568691343





CEB #: 1000039538

NICL LABORATORIES - CRYSTAL LAKEProvider Type: Independent Laboratories

Address: 455 COVENTRY LN - STE 106, CRYSTAL LAKE IL 60014Phone: 815-455-9525 Network: NICL LABORATORIES

Pri. Hospital:


Pri. Specialty: LAB Sec. Specialty:

NPI: 1659373900





CEB #: 1000063897

NICL LABORATORIES - MCHENRYProvider Type: Independent Laboratories

Address: 616 S ROUTE 31 - STE G, MCHENRY IL 60050Phone: 815-578-1547 Network: NICL LABORATORIES

Pri. Hospital:



NPI: 1659373900





CEB #: 1000092912

NICL LABORATORIES - WOODSTOCKProvider Type: Independent Laboratories

Address: 242 THROOP ST , WOOD STOCK IL 60098Phone: 815-338-6596 Network: NICL LABORATORIES

Pri. Hospital:



NPI: 1659373900





CEB #: 1000092915

FAMILY ALLIANCE INCProvider Type: Mental Health Day Training

Address: 2028 N SEMINARY AVE , WOODSTOCK IL 60098Phone: 815-338-3590 Network: FAMILY ALLIANCE INC

Pri. Hospital:


Pri. Specialty: MENTAL HEALTH SERVICES Sec. Specialty: ADULT DAY SERVICES

NPI: 1598717597





CEB #: 1000055479

3


CRYSTAL PINES REHAB AND HEALTH CARE CENTERProvider Type: Nursing Facilities

Address: 335 N ILLINOIS ST , CRYSTAL LAKE IL 60014Phone: 815-459-7791 Network: CRYSTAL PINES REHAB AND HEALTH CARE CENTER

Pri. Hospital:


Pri. Specialty: SKILLED NURSING Sec. Specialty:

NPI: 1952301822





CEB #: 1000066815

ALDEN TERRACE OF MCHENRY REHABProvider Type: Nursing Facilities

Address: 803 ROYAL DR , MCHENRY IL 60050Phone: 815-344-2600 Network: ALDEN MANAGEMENT SERVICES INC

Pri. Hospital:


Pri. Specialty: SKILLED NURSING FACILITY Sec. Specialty: DME

NPI: 1023005519





CEB #: 1000079221

HERITAGE WOODS OF MCHENRYProvider Type: Supportive Living Facility

Address: 4609 W CRYSTAL LAKE RD , MCHENRY IL 60050Phone: 815-344-2690 Network: HERITAGE WOODS OF MCHENRY

Pri. Hospital:



NPI: 1801047832





CEB #: 1000085720

4


IL - OGLENEIGHBORS REHABILITATION CNTRProvider Type: Nursing Facilities

Address: 811 W 2ND ST , BYRON IL 61010Phone: 815-234-2511 Network: NEIGHBORS REHABILITATION CENTER

Pri. Hospital:


Pri. Specialty: HOME HEALTH Sec. Specialty: MENTAL HEALTH COUNSELOR

NPI: 1598754764





CEB #: 1000039421

5


IL - WINNEBAGOMETRO MEDICAL SERVICES INCProvider Type: Ambulance Service Providers

Address: 5112 FOREST HILL CT , LOVES PARK IL 61111Phone: 815-847-7211 Network: TRANSPORTATION SERVICES

Pri. Hospital:


Pri. Specialty: TRANSPORTATION Sec. Specialty:

NPI: 1720045859





CEB #: 1000039581

LIFELINE AMBULANCE LLCProvider Type: Ambulance Service Providers

Address: 318 ROXBURY RD , ROCKFORD IL 61107Phone: 815-395-4637 Network: OSF HEALTHCARE SYSTEM

Pri. Hospital:



NPI: 1619036829





CEB #: 1000107742

COMPREHENSIVE PROSTHETICS ORTHProvider Type: Durable Medical Equipment/Supply

Address: 535 ROXBURY RD - LOWER LEVEL, ROCKFORD IL 61107Phone: 800-334-5705 Network: COMPREHENSIVE PROSTHETICS ORTH

Pri. Hospital:



NPI: 1174573307





CEB #: 1000063764

INTEGRATED HOMECARE SERVS INCProvider Type: Durable Medical Equipment/Supply

Address: 5027 HARRISON AVE , ROCKFORD IL 61108Phone: 815-747-6994 Network: INTEGRATED HOMECARE SERVICES

Pri. Hospital:



NPI: 1396855821





CEB #: 1000006620

MOBILITY CONNECTION INCProvider Type: Durable Medical Equipment/Supply

Address: 4100 E STATE ST , ROCKFORD IL 61108Phone: 815-965-8090 Network: MOBILITY CONNECTION INC

Pri. Hospital:


Pri. Specialty: DME Sec. Specialty: TRANSPORTATION

NPI: 1225142813





CEB #: 1000085575

6


NORTHERN PROSTHETICS ORTHOProvider Type: Durable Medical Equipment/Supply

Address: 2629 CHARLES ST , ROCKFORD IL 61108Phone: 815-226-0444 Network: NORTHERN PROSTHETICS & ORTHOPEDIC INC

Pri. Hospital:


Pri. Specialty: DME Sec. Specialty: ORTHOTICS & PROSTHETICS

NPI: 1194719328





CEB #: 1000085624

OSF HOME MEDICAL EQUIPMENTProvider Type: Durable Medical Equipment/Supply

Address: 5501 E STATE ST , ROCKFORD IL 61108Phone: 815-381-6350 Network: OSF HEALTHCARE SYSTEM

Pri. Hospital:



NPI: 1013925593





CEB #: 1000092567

RENAL TREATMENT CENTERSProvider Type: General Hospitals

Address: 417 WARE AVE , ROCKFORD IL 61107Phone: 815-397-4123 Network: DAVITA HEALTHCARE PARTNERS INC

Pri. Hospital:



NPI: 1285694729





CEB #: 1000041286

ROXBURY DIALYSIS CENTERProvider Type: General Hospitals

Address: 622 ROXBURY RD , ROCKFORD IL 61107Phone: 815-397-0713 Network: DAVITA HEALTHCARE PARTNERS INC

Pri. Hospital:



NPI: 1003875402





CEB #: 1000041323

STONECREST DIALYSISProvider Type: General Hospitals

Address: 1302 E STATE ST , ROCKFORD IL 61104Phone: 815-968-5794 Network: DAVITA HEALTHCARE PARTNERS INC

Pri. Hospital:



NPI: 1518276955





CEB #: 1000041505

7


ST ANTHONYS HOSP MEDICAL CTRProvider Type: Home Health Agencies - In Home


Pri. Hospital:


Pri. Specialty: HOME HEALTH Sec. Specialty:

NPI: 1023051992





CEB #: 1000092320

SWEDISHAMERICAN HOME HEALTHProvider Type: Home Health Agencies - In Home

Address: 2550 CHARLES ST , ROCKFORD IL 61108Phone: 779-696-7550 Network: SWEDISHAMERICAN HOME HEALTH

Pri. Hospital:



NPI: 1255439774





CEB #: 1000082358

HEARTLAND HOSPICE SERVICESProvider Type: Hospice

Address: 363 FINANCIAL CT - UNIT 300, ROCKFORD IL 61107Phone: 866-216-5708 Network: HEARTLAND HOSPICE SERVICES LLC & IN HOME HEALTH

Pri. Hospital:


Pri. Specialty: HOSPICE Sec. Specialty:

NPI: 1578516290





CEB #: 1000089072

HOSPICE CARE OF AMERICA INCProvider Type: Hospice

Address: 3815 N MULFORD RD , ROCKFORD IL 61114Phone: Network: HOSPICE CARE OF AMERICA INC

Pri. Hospital:


Pri. Specialty: HOSPICE Sec. Specialty: HOSPICE & PALLIATIVE MEDICINE

NPI: 1659301539





CEB #: 1000059643

NORTHERN IL HOSPICE ASSOCProvider Type: Hospice

Address: 4215 NEWBURG RD , ROCKFORD IL 61108Phone: 815-398-0500 Network: NORTHERN IL HOSPICE ASSOCIATION

Pri. Hospital:



NPI: 1700884731





CEB #: 1000087052

8


OSF HOSPICEProvider Type: Hospice


Pri. Hospital:



NPI: 1518997857





CEB #: 1000092335

ADDUS HEALTHCARE INCProvider Type: In Home Care - Department of Aging

Address: 5301 E STATE ST - STE 118, ROCKFORD IL 61108Phone: 815-229-0300 Network: ADDUS HEALTHCARE

Pri. Hospital:


Pri. Specialty: HOMEMAKER Sec. Specialty:

NPI: 1609191865




Hrs: Mon: 08:00 - 17:00 Tue: 08:00 - 17:00 Wed: 08:00 - 17:00 Thu: 08:00 - 17:00Accepts Medicaid: Yes

CEB #: 1000092751

EUROPEAN SERVICE AT HOME - ROCKFORDProvider Type: In Home Care - Department of Aging

Address: 815 N CHURCH ST - STE 105, rockford IL 61103Phone: 815-489-9000 Network: EUROPEAN SERVICE AT HOME INC

Pri. Hospital:



NPI: 1720349442





CEB #: 1000080550

EUROPEAN SERVICE AT HOME INCProvider Type: In Home Care - Department of Aging

Address: 815 N CHURCH ST - STE 105, ROCKFORD IL 61103Phone: 815-489-9000 Network: EUROPEAN SERVICE AT HOME INC

Pri. Hospital:



NPI: 1720349442





CEB #: 1000108370

HEALTHCARE PLUS HOMEMAKERS LLCProvider Type: In Home Care - Department of Aging

Address: 5301 E STATE ST - STE 205, ROCKFORD IL 61108Phone: 773-283-0090 Network: HEALTHCARE PLUS HOMEMAKERS LLC

Pri. Hospital:



NPI: 1235471566





CEB #: 1000100756

9


SISTERS HOME HEALTH SERV INCProvider Type: In Home Care - Department of Aging

Address: 1214 E STATE ST , ROCKFORD IL 61104Phone: 815-961-2170 Network: SISTERS HOME HEALTH SERV INC

Pri. Hospital:


Pri. Specialty: HOME HEALTH Sec. Specialty: WOUND CARE

NPI: 1356469688





CEB #: 1000039460

VISITING NURSES ASSOCIATIONProvider Type: In Home Care / DHS - Rehab. Services

Address: 4223 E STATE ST , ROCKFORD IL 61108Phone: 815-971-3550 Network: ROCKFORD HEALTH SYSTEM

Pri. Hospital:



NPI: 1093821654





CEB #: 1000087979

NICL LABORATORIES - ROCKFORDProvider Type: Independent Laboratories

Address: 483 N MULFORD RD - STE 2, ROCKFORD IL 61107Phone: 815-977-4349 Network: NICL LABORATORIES

Pri. Hospital:



NPI: 1659373900





CEB #: 1000092901

MIDWEST MEDIVAN INCProvider Type: Medicar Provider

Address: 975 N MAIN ST , ROCKFORD IL 61103Phone: 815-977-7007 Network: TRANSPORTATION SERVICES

Pri. Hospital:



NPI: 1245532530





CEB #: 1000039648

ALDEN ALMA NELSON MANORProvider Type: Nursing Facilities

Address: 550 S MULFORD RD , ROCKFORD IL 61108Phone: 815-484-1002 Network: ALDEN MANAGEMENT SERVICES INC

Pri. Hospital:



NPI: 1619963816





CEB #: 1000079097

10


ALDEN PARK STRATHMOORProvider Type: Nursing Facilities

Address: 5668 straTHMOOR INC , ROCKFORD IL 61107Phone: 815-229-5200 Network: ALDEN MANAGEMENT SERVICES INC

Pri. Hospital:



NPI: 1376530766





CEB #: 1000079202

AMBERWOOD CARE CENTREProvider Type: Nursing Facilities

Address: 2313 N ROCKTON AVE , ROCKFORD IL 61103Phone: 815-964-2200 Network: AMBERWOOD CARE CENTRE

Pri. Hospital:


Pri. Specialty: LONG TERM CARE FACILITY Sec. Specialty: SKILLED NURSING

NPI: 1245576735





CEB #: 1000039480

FAIRVIEW NURSING PLAZA INCProvider Type: Nursing Facilities

Address: 321 ARNOLD AVE , ROCKFORD IL 61108Phone: 815-397-5531 Network: FAIRVIEW NURSING PLAZA INC

Pri. Hospital:


Pri. Specialty: SKILLED NURSING FACILITY Sec. Specialty:

NPI: 1851396238





CEB #: 1000006525

FAIR OAKS REHAB AND HCCProvider Type: Nursing Facilities

Address: 1515 BLACKHAWK , SOUTH BELOIT IL 61080Phone: 815-389-3911 Network: FAIR OAKS REHAB AND HEALTH CARE CENTER

Pri. Hospital:



NPI: 1578563441





CEB #: 1000067262

OSF HOME INFUSION PHARMACYProvider Type: Pharmacy

Address: 9951 ROCK CUT CROSSING , LOVES PARK IL 61111Phone: 815-921-8780 Network: OSF HEALTHCARE SYSTEM

Pri. Hospital:


Pri. Specialty: INFUSION THERAPY Sec. Specialty:

NPI: 1831104546





CEB #: 1000092317

11


SWEDISHAMERICAN INFUSION SRVCProvider Type: Pharmacy

Address: 2550 CHARLES ST , ROCKFORD IL 61108Phone: 815-391-7550 Network: SWEDISHAMERICAN INFUSION SRVC

Pri. Hospital:


Pri. Specialty: INFUSION THERAPY Sec. Specialty:

NPI: 1285720763





CEB #: 1000082363

HERITAGE WOODS OF ROCKFORDProvider Type: Supportive Living Facility

Address: 202 N SHOWPLACE DR , ROCKFORD IL 61107Phone: 815-332-3700 Network: HERITAGE WOODS OF ROCKFORD

Pri. Hospital:



NPI: 1417142225





CEB #: 1000085721

ROCKFORD SUPPORTIVE LIVINGProvider Type: Supportive Living Facility

Address: 2114 KISHWAUKEE ST , ROCKFORD IL 61104Phone: 815-966-1030 Network: ROCKFORD SUPPORTIVE LIVING

Pri. Hospital:


Pri. Specialty: SKILLED NURSING FACILITY Sec. Specialty: EMERGENCY HOME RESPONSE

NPI: 1609907740





CEB #: 1000085755

PROFESSIONAL MED STAFFING INCProvider Type: TBI Home and Community-based services Medicaid w

Address: 1848 DAIMLER RD , ROCKFORD IL 61112Phone: 815-227-0093 Network: PROFESSIONAL MED STAFFING INC

Pri. Hospital:



NPI: 1104027242





CEB #: 1000080371

12


Provider Directory

Rockford‐area

Skilled Nursing Facility

IL - BOONEPARK PLACE OF BELVIDEREProvider Type: Nursing Facilities

Address: 1701 W 5TH AVE , BELVIDERE IL 61008Phone: 847-311-2675 Network: PARK PLACE OF BELVIDERE

Pri. Hospital:



NPI: 1801233846





CEB #: 1000066479

1

Skilled Nursing Facility - CCAI MA ( Rockford )Member Services: 1-855-275-2781 9 Provider(s) TTY: 711

IL - MCHENRYCRYSTAL PINES REHAB AND HEALTH CARE CENTERProvider Type: Nursing Facilities

Address: 335 N ILLINOIS ST , CRYSTAL LAKE IL 60014Phone: 815-459-7791 Network: CRYSTAL PINES REHAB AND HEALTH CARE CENTER

Pri. Hospital:


Pri. Specialty: SKILLED NURSING Sec. Specialty:

NPI: 1952301822





CEB #: 1000066815

ALDEN TERRACE OF MCHENRY REHABProvider Type: Nursing Facilities

Address: 803 ROYAL DR , MCHENRY IL 60050Phone: 815-344-2600 Network: ALDEN MANAGEMENT SERVICES INC

Pri. Hospital:



NPI: 1023005519





CEB #: 1000079221

2


IL - OGLENEIGHBORS REHABILITATION CNTRProvider Type: Nursing Facilities

Address: 811 W 2ND ST , BYRON IL 61010Phone: 815-234-2511 Network: NEIGHBORS REHABILITATION CENTER

Pri. Hospital:


Pri. Specialty: HOME HEALTH Sec. Specialty: MENTAL HEALTH COUNSELOR

NPI: 1598754764





CEB #: 1000039421

3


IL - WINNEBAGOALDEN ALMA NELSON MANORProvider Type: Nursing Facilities

Address: 550 S MULFORD RD , ROCKFORD IL 61108Phone: 815-484-1002 Network: ALDEN MANAGEMENT SERVICES INC

Pri. Hospital:



NPI: 1619963816





CEB #: 1000079097

ALDEN PARK STRATHMOORProvider Type: Nursing Facilities

Address: 5668 straTHMOOR INC , ROCKFORD IL 61107Phone: 815-229-5200 Network: ALDEN MANAGEMENT SERVICES INC

Pri. Hospital:



NPI: 1376530766





CEB #: 1000079202

AMBERWOOD CARE CENTREProvider Type: Nursing Facilities

Address: 2313 N ROCKTON AVE , ROCKFORD IL 61103Phone: 815-964-2200 Network: AMBERWOOD CARE CENTRE

Pri. Hospital:


Pri. Specialty: LONG TERM CARE FACILITY Sec. Specialty: SKILLED NURSING

NPI: 1245576735





CEB #: 1000039480

FAIRVIEW NURSING PLAZA INCProvider Type: Nursing Facilities

Address: 321 ARNOLD AVE , ROCKFORD IL 61108Phone: 815-397-5531 Network: FAIRVIEW NURSING PLAZA INC

Pri. Hospital:


Pri. Specialty: SKILLED NURSING FACILITY Sec. Specialty:

NPI: 1851396238





CEB #: 1000006525

FAIR OAKS REHAB AND HCCProvider Type: Nursing Facilities

Address: 1515 BLACKHAWK , SOUTH BELOIT IL 61080Phone: 815-389-3911 Network: FAIR OAKS REHAB AND HEALTH CARE CENTER

Pri. Hospital:



NPI: 1578563441





CEB #: 1000067262

4

Provider directoryCommunity Complete (D-SNP) • Community Advantage (HMO)

H3071_OP P008_099_073015 Accepted 10/2/2015

Visit us online at www.ccaillinois.com/medicareMember Services 1-855-275-1781 (TTY/TDD 711)

Hours are between 8:00am and 8:00pm Monday through Friday (7 days a week from October 1 through February 14).

Answering Service is available weekends and after hours.

rockford area - community care alliance of illinois...rockford area boone, mchenry, ogle and...

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