Organization
SWEDISHAMERICAN HOSPITAL
Active
Organization
SWEDISHAMERICAN HOSPITAL
Active
Other names
SwedishAmerican Heart Institute a Department of SwedishAmerican Hosp
Organization subpart
No
Provider details
NPI number
Authorized official
DON DANIELS (VP)
(815) 966-2084
Entity
Organization
Contact information
Practice address
1340 CHARLES ST, SUITE 300, ROCKFORD, IL 61104
(779) 696-5888
Mailing address
PO BOX 78866, MILWAUKEE, WI 53278-8866
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14D1023896
CLIA
IL
Enumeration date
01/24/2007
Last updated
07/12/2018
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