MEDICARE: COUNTY OF WINNEBAGO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	0005611	IL

General Provider Information

NPI Number	:	1316931082
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF WINNEBAGO

Provider Business Mailing Address
First Line	:	4401 N MAIN ST
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61103-1277
Country	:	US
Telephone Number	:	815-921-9200
Fax Number	:	815-877-1069

Provider Business Practice Location Address
First Line	:	404 ELM ST
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61101-1239
Country	:	US
Telephone Number	:	815-921-9200
Fax Number	:	815-877-1069

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	LAURA M SCHAFFER
Credential	:	BSN, RN
Telephone Number	:	815-921-9200

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	01/29/2024

Similar Medicare Providers

1992155766 — COUNTY OF WINNEBAGO
Practice Location Address:

404 ELM ST
ROCKFORD, IL
61101-1239

Practice Phone: 815-921-9200
Practice Fax: 815-877-8304

1295723021 — DR. KAMLESH P RAMCHANDANI M.D.
Practice Location Address:

111 N CHURCH ST
ROCKFORD, IL
61101-1001

Practice Phone: 815-962-0394
Practice Fax: 815-962-5163

1396727970 — MR. NICHOLAS J MANNO MD
Practice Location Address:

2825 GLENWOOD AVE
ROCKFORD, IL
61101-3542

Practice Phone: 815-965-9548
Practice Fax: 815-965-9712

1053383737 — SHAHINA H JAFRY M.D.
Practice Location Address:

526 W. STATE STREET
ROCKFORD, IL
61101-1214

Practice Phone: 815-968-9300
Practice Fax: 815-968-5314

1750345872 — MICHAEL A KUNA M.D.
Practice Location Address:

526 W. STATE STREET , SUITE 206
ROCKFORD, IL
61101-1214

Practice Phone: 815-968-9300
Practice Fax: 815-968-5314

1558327544 — JANET WATTLES CENTER
Practice Location Address:

526 W STATE ST
ROCKFORD, IL
61101-1214

Practice Phone: 815-968-9300
Practice Fax: 815-968-5314

Directions to “COUNTY OF WINNEBAGO ” Practice Location

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