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General NPI Number Information
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NPI Number | 1447207741
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Entity Type | Organization
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Legal Business Name | ROCKFORD GASTROENTEROLOGY ASSOCIATES, LTD.
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Dates
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Enumeration Date | 05/30/2006
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 401 ROXBURY RD
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City | ROCKFORD
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State | IL
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Zip | 61107-5075
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Country | US
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Telephone | 815-397-7340
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Fax | 815-397-7388
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Provider Business Mailing Address
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Address Line | 401 ROXBURY RD
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City | ROCKFORD
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State | IL
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Zip | 61107-5078
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Country | US
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Telephone | 815-397-7340
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Fax | 815-397-7388
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Authorized Official
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Title or Position | CEO
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Name | MS. NICCOLE RANZ
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Credential | FNP-C
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Telephone | 815-397-7340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology 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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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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 #7
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 042004145
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License Number State | IL
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