Organization
SWEDISHAMERICAN HOSPITAL
Active
Other names
SwedishAmerican Home Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANN M GANTZER PHD (VICE PRESIDENT OF PATIENT SERVICES)
(815) 961-2030
Entity
Organization
Contact information
Practice address
2550 CHARLES ST, ROCKFORD, IL 61108-1673
(779) 696-7550
(815) 391-7501
Mailing address
2550 CHARLES ST, ROCKFORD, IL 61108-1673
(779) 696-7550
(815) 391-7501
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1003169
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50309
BLUE CROSS BLUE SHIELD
IL
Enumeration date
09/20/2006
Last updated
02/06/2015
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