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General NPI Number Information
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NPI Number | 1538527395
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Entity Type | Individual
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Provider Name | REBEKAH SOOY PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/08/2016
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 5666 E STATE ST
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City | ROCKFORD
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State | IL
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Zip | 61108-2425
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Country | US
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Telephone | 815-226-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 1217 HENDRICKS AVE
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City | JACKSONVILLE
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State | NC
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Zip | 28540-3858
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Country | US
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Telephone | 502-655-2313
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 029215-01
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601010940
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 50.005253RX
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MA062843
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-12690
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License Number State | NC
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Taxonomy #6
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 085.009765
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License Number State | IL
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