# ROCKFORD MEDICAL REHABILITATION SC

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

## Provider details

- **NPI number:** 1831397629
- **Authorized official:** PETER E SMITH (BILLING AGENT)
- **Authorized official phone:** (815) 965-8505

## Contact information

- **Practice address:** 950 S MULFORD RD, ROCKFORD, IL 61108-4274
- **Practice address phone:** (815) 381-8574
- **Mailing address:** 4525 FOREST VIEW AVE, ROCKFORD, IL 61108-6406
- **Mailing address phone:** (815) 965-8505
- **Mailing address fax:** (815) 965-8440

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/03/2007
- **Last updated:** 08/22/2020