Organization
SWEDISHAMERICAN HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DON DANIELS (VP)
(815) 966-2084
Entity
Organization
Contact information
Practice address
1401 E STATE ST, ROCKFORD, IL 61104
(815) 961-2030
Mailing address
PO BOX 78866, MILWAUKEE, WI 53278-8866
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
163WW0000X
Wound Care Registered Nurse
—
—
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
207T00000X
Neurological Surgery Physician
—
—
207VM0101X
Maternal & Fetal Medicine Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14D0044064
CLIA
IL
01
—
1962451732
GROUP NPI
—
Enumeration date
01/24/2007
Last updated
07/12/2018
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