MEDICARE: BELOIT HEALTH SYSTEM INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207WX0108X	Uveitis and Ocular Inflammatory Disease (Ophthalmology) Physician
2	261QE0800X	Endoscopy Clinic/Center
3	261QP1100X	Podiatric Clinic/Center
4	261QP3300X	Pain Clinic/Center
5	261QA1903X	Ambulatory Surgical Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790353753
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BELOIT HEALTH SYSTEM INC

Provider Business Mailing Address
First Line	:	1905 E HUEBBE PKWY FL 5
Second Line	:
City	:	BELOIT
State	:	WI
Zip	:	53511-1842
Country	:	US
Telephone Number	:	608-364-1615
Fax Number	:

Provider Business Practice Location Address
First Line	:	5605 E ROCKTON RD
Second Line	:
City	:	ROSCOE
State	:	IL
Zip	:	61073-7601
Country	:	US
Telephone Number	:	815-525-4000
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT OF FINANCE/CFO
Name	:	JAMES F BIRD
Credential	:	MBS, CPA
Telephone Number	:	608-364-5281

Provider Enumeration Date	:	06/16/2021
Last Update Date	:	07/07/2023

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Directions to “BELOIT HEALTH SYSTEM INC ” Practice Location

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