Organization
BELOIT CLINIC SC
Active
Parent organization
BELOIT CLINIC SC
Other names
Roscoe Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
BELOIT CLINIC SC
Authorized official
WILLIAM P SULLIVAN CEO (ADMINISTRATOR)
(608) 364-2200
Entity
Organization
Contact information
Practice address
5605 EAST ROCKTON RD, NORTH POINTE, ROSCOE, IL 61073-7601
(815) 525-4500
(608) 364-2338
Mailing address
1905 HUEBBE PARKWAY, BELOIT CLINIC SC, BELOIT, WI 53511-1842
(608) 364-2200
(608) 364-2338
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32270100
—
WI
05
—
32808500
—
WI
01
—
483240
ILLINOIS MEDICARE
—
Enumeration date
03/19/2007
Last updated
02/06/2008
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