# LUNDHOLM SURGICAL GROUP LTD

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

## Provider details

- **NPI number:** 1790752434
- **Authorized official:** SCOTT R NYGUIST MD (MD)
- **Authorized official phone:** (815) 397-6723

## Contact information

- **Practice address:** 1340 CHARLES ST, ROCKFORD, IL 61104
- **Practice address phone:** (815) 397-4890
- **Practice address fax:** (815) 397-5926
- **Mailing address:** PO BOX 4117, ROCKFORD, IL 61110-0617
- **Mailing address phone:** (815) 397-4890
- **Mailing address fax:** (815) 397-5926

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/01/2006
- **Last updated:** 08/22/2020