MEDICARE: ROCKFORD UNIVERSITY

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	261QS1000X	Student Health Clinic/Center

General Provider Information

NPI Number	:	1538047899
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCKFORD UNIVERSITY

Provider Business Mailing Address
First Line	:	5050 E STATE ST
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61108-2311
Country	:	US
Telephone Number	:	815-226-4083
Fax Number	:	815-226-3335

Provider Business Practice Location Address
First Line	:	5050 E STATE ST
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61108-2311
Country	:	US
Telephone Number	:	815-226-4083
Fax Number	:	815-226-3335

Authorized Official
Title or Position	:	VP FOR FINANCE & CHIEF FINANCIAL OF
Name	:	JOHN DIRAIMONDO
Credential	:
Telephone Number	:	815-226-4006

Provider Enumeration Date	:	08/25/2025
Last Update Date	:	08/25/2025

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Directions to “ROCKFORD UNIVERSITY ” Practice Location

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