Organization
FEATHERSTONE PARTNERSHIP LP
Active
Other names
Rockford Ambulatory Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN GUNDERSON D.O. (MEDICAL DIRECTOR)
(815) 231-5450
Entity
Organization
Contact information
Practice address
1016 FEATHERSTONE RD, ROCKFORD, IL 61107-5902
(815) 226-3300
(815) 226-9990
Mailing address
PO BOX 4661, ROCKFORD, IL 61110-4661
(815) 226-3300
(815) 226-9990
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
7001928
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
490002678
RAILROAD MEDICARE PRO #
IL
Enumeration date
05/19/2006
Last updated
10/05/2020
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