Organization
CEVENE CARE CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGELA RUF (MANAGER)
(815) 639-9900
Entity
Organization
Contact information
Practice address
6451 E RIVERSIDE BLVD, #103, ROCKFORD, IL 61114-4421
(815) 639-9900
(815) 639-9860
Mailing address
6451 E RIVERSIDE BLVD, #103, ROCKFORD, IL 61114-4421
(815) 639-9900
(815) 639-9860
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
149009052
IL
111N00000X
Chiropractor
Primary
038009573
IL
111NR0400X
Rehabilitation Chiropractor
038009573
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
336045953
IL
208D00000X
General Practice Physician
036118972
IL
213E00000X
Podiatrist
31602516
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
016005320
IL
225100000X
Physical Therapist
0070009799
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
210693
MEDICARE GROUP #
IL
Enumeration date
03/26/2007
Last updated
04/18/2016
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