Organization
BELOIT CLINIC SC
Active
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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