Organization
VIVEK THAPPA, M.D., S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIVEK THAPPA M.D. (PHYSICIAN)
(815) 316-1899
Entity
Organization
Contact information
Practice address
1235 N MULFORD RD, SUITE 100, ROCKFORD, IL 61107-3879
(815) 316-1899
(815) 316-1897
Mailing address
PO BOX 5023, ROCKFORD, IL 61125-0023
(815) 316-1899
(815) 316-1897
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036081657
IL
207RP1001X
Pulmonary Disease Physician
Primary
036081657
IL
207RS0012X
Sleep Medicine (Internal Medicine) Physician
036081657
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036081657
—
IL
01
—
101-04711
BLUE CROSS BLUE SHIELD
—
Enumeration date
12/14/2007
Last updated
05/27/2008
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