Organization
SWEDISHAMERICAN HOSPITAL
Active
Other names
Baptist Pediatric Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DON DANIELS (VP)
(815) 966-2084
Entity
Organization
Contact information
Practice address
461 N MULFORD RD STE 4, ROCKFORD, IL 61107-5165
(815) 397-2400
(815) 397-1879
Mailing address
PO BOX 78866, MILWAUKEE, WI 53278-8866
(779) 696-7150
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
07/28/2016
Last updated
05/15/2020
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