Organization
UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION
Active
Other names
Retina Consultants, UWMF
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY GROSSMAN MD (PRESIDENT AND CEO)
(815) 399-1141
Entity
Organization
Contact information
Practice address
345 EXECUTIVE PKWY, SUITE M4, ROCKFORD, IL 61107-5340
(815) 399-1141
(815) 397-7816
Mailing address
345 EXECUTIVE PKWY, SUITE M4, ROCKFORD, IL 61107-5340
(815) 399-1141
(815) 397-7816
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10121807
BCBS OF IL GROUP NUMBER
IL
Enumeration date
04/04/2007
Last updated
08/22/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up