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General NPI Number Information
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NPI Number | 1881877686
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Entity Type | Organization
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Legal Business Name | VIVEK THAPPA, M.D., S.C.
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Dates
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Enumeration Date | 12/14/2007
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Last Update Date | 05/27/2008
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Provider Practice Location Address
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Address Line | 1235 N MULFORD RD SUITE 100
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City | ROCKFORD
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State | IL
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Zip | 61107-3879
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Country | US
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Telephone | 815-316-1899
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Fax | 815-316-1897
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Provider Business Mailing Address
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Address Line | PO BOX 5023
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City | ROCKFORD
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State | IL
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Zip | 61125-0023
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Country | US
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Telephone | 815-316-1899
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Fax | 815-316-1897
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Authorized Official
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Title or Position | PHYSICIAN
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Name | VIVEK THAPPA
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Credential | M.D.
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Telephone | 815-316-1899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) 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 | 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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Taxonomy #3
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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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