# ROCKFORD SURGICAL SERVICE, S.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073679411
- **Authorized official:** LESLIE P EDGCOMB M.D. (PRESIDENT)
- **Authorized official phone:** (815) 397-7900

## Contact information

- **Practice address:** 5668 E STATE ST, SUITE1000, ROCKFORD, IL 61108-2490
- **Practice address phone:** (815) 397-7900
- **Practice address fax:** (815) 397-7919
- **Mailing address:** 5668 E STATE ST, SUITE1000, ROCKFORD, IL 61108-2490
- **Mailing address phone:** (815) 397-7900
- **Mailing address fax:** (815) 397-7919

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | IL | Yes |

## Other

- **Enumeration date:** 12/29/2006
- **Last updated:** 09/11/2025