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NPI Code Detail

MEDICARE: NAHD SC

MEDICARE: NAHD SC
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
1174400000XSpecialistIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1K170159OTHERILMEMBER #

General Provider Information

NPI Number : 1881695468
Entity Type Code : Organization
Provider Name (Legal Business Name) : NAHD SC
Provider Business Mailing Address
First Line : 7402 E RIVERSIDE BLVD
Second Line :
City : LOVES PARK
State : IL
Zip : 61111-5630
Country : US
Telephone Number : 815-226-9642
Fax Number : 815-226-9672
Provider Business Practice Location Address
First Line : 7402 E RIVERSIDE BLVD
Second Line :
City : LOVES PARK
State : IL
Zip : 61111-5630
Country : US
Telephone Number : 815-226-9642
Fax Number : 815-226-9672
Authorized Official
Title or Position : OWNER
Name : DR. NICOLE ANN HARTSOUGH
Credential : MD
Telephone Number : 815-226-9642
Provider Enumeration Date : 08/09/2005
Last Update Date : 11/02/2007

Similar Medicare Providers

1962400382 — DR. NICOLE ANN HARTSOUGH M.D.
Practice Location Address:
7402 E RIVERSIDE BLVD
LOVES PARK, IL
61111-5630
Practice Phone: 815-226-9642
Practice Fax: 815-226-9672
1326028143 — MR. KEVIN M. BURNS PA-C
Practice Location Address:
7402 E RIVERSIDE BLVD
LOVES PARK, IL
61111-5630
Practice Phone: 815-226-9642
Practice Fax: 815-226-9672
1992907893 — DR. AASHISH TANEJA MD
Practice Location Address:
7402 E RIVERSIDE BLVD
LOVES PARK, IL
61111-5630
Practice Phone: 815-971-3920
Practice Fax: 815-226-9672
1912796863 — MRS. REBECA FRANCES PRITCHARD MSN, APRN, FNP-BC
Practice Location Address:
7402 E RIVERSIDE BLVD
LOVES PARK, IL
61111-5630
Practice Phone: 815-971-7400
Practice Fax:
1952272205 — ROCKFORD HEALTH PHYSICIANS
Practice Location Address:
7402 E RIVERSIDE BLVD
LOVES PARK, IL
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Practice Phone: 815-971-7400
Practice Fax: 815-971-9460
1770723454 — DIANE ASHLEY M.S.ED., CAS
Practice Location Address:
104 QUAIL RUN DR
DEER PARK, NY
11729-5630
Practice Phone: 631-940-3258
Practice Fax:

Directions to “NAHD SC ” Practice Location

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