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Organization
ROCKFORD SURGICAL SERVICE, S.C.
Active
Organization
ROCKFORD SURGICAL SERVICE, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE P EDGCOMB M.D. (PRESIDENT)
(815) 397-7900
Entity
Organization
Contact information
Practice address
5668 E STATE ST, SUITE1000, ROCKFORD, IL 61108-2490
(815) 397-7900
(815) 397-7919
Mailing address
5668 E STATE ST, SUITE1000, ROCKFORD, IL 61108-2490
(815) 397-7900
(815) 397-7919
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
IL
2086S0102X
Surgical Critical Care Physician
04200060
IL
2086S0129X
Vascular Surgery Physician
—
IL
208C00000X
Colon & Rectal Surgery Physician
—
IL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
IL
Other
Enumeration date
12/29/2006
Last updated
09/11/2025
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