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General NPI Number Information
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NPI Number | 1124173851
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Entity Type | Organization
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Legal Business Name | SWEDISHAMERICAN HOSPITAL
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 07/12/2018
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Provider Practice Location Address
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Address Line | 209 9TH ST SUITE 200
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City | ROCKFORD
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State | IL
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Zip | 61104
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Country | US
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Telephone | 779-696-2750
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 78866
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City | MILWAUKEE
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State | WI
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Zip | 53278-8866
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP
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Name | DON DANIELS
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Credential |
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Telephone | 815-966-2084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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