Organization
SWEDISHAMERICAN HOSPITAL
Active
Other names
SwedishAmerican Regional Cancer Center
Organization subpart
No
Provider details
NPI number
Authorized official
DON DANIELS (VP)
(815) 961-2030
Entity
Organization
Contact information
Practice address
3535 N BELL SCHOOL RD, ROCKFORD, IL 61114
(779) 696-9400
Mailing address
PO BOX 78866, MILWAUKEE, WI 53278-8866
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
2085R0001X
Radiation Oncology Physician
—
—
208600000X
Surgery Physician
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080
TRICARE SUFFIX #
IL
01
—
14D2066113
CLIA
IL
Enumeration date
08/06/2013
Last updated
07/12/2018
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