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General NPI Number Information
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NPI Number | 1154698264
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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 | 11/18/2011
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Last Update Date | 02/24/2012
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Provider Practice Location Address
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Address Line | 209 9TH ST SUITE 301
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City | ROCKFORD
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State | IL
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Zip | 61104-2235
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Country | US
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Telephone | 815-489-4429
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1567
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City | ROCKFORD
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State | IL
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Zip | 61110-0067
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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 | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | 036081657
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 036081657
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 036081657
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License Number State | IL
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