Healthcare Provider Details

I. General information

NPI: 1730138884
Provider Name (Legal Business Name): ROCK RIVER HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E LEFEVRE ROAD
STERLING IL
61081
US

IV. Provider business mailing address

100 E LEFEVRE ROAD
STERLING IL
61081
US

V. Phone/Fax

Practice location:
  • Phone: 815-625-0400
  • Fax:
Mailing address:
  • Phone: 815-625-0400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. EDWARD ANDERSEN
Title or Position: CEO
Credential:
Phone: 815-625-0400