Organization
ROCKFORD ANESTHESIOLOGISTS ASSOCIATED, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRYAN J. NEWMAN (DIRECTOR OF ACCOUNTING)
(815) 877-4848
Entity
Organization
Contact information
Practice address
2202 HARLEM RD, LOVES PARK, IL 61111-2754
(815) 877-4848
(815) 654-5342
Mailing address
2202 HARLEM RD, LOVES PARK, IL 61111-2754
(815) 877-4848
(815) 654-5342
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10115335
BCBS
IL
01
—
CK0730
RAILROAD MEDICARE
—
Enumeration date
05/09/2006
Last updated
01/20/2016
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