Rockford Surgical Service, S.C.
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Rockford, IL. Organization (NPI-2).
NPI number1073679411
StatusActive
Last updated in NPPESSep 11, 2025
Details
- NPI
- 1073679411
- Entity type
- Organization (NPI-2)
- Legal business name
- Rockford Surgical Service, S.C.
- Organization subpart
- No
- Enumeration date
- Dec 29, 2006
- Last updated
- Sep 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 042000060 | IL | Yes |
| 208600000X | Surgery | 042000060 | IL | |
| 2086S0102X | Surgery, Surgical Critical Care | 04200060 | IL | |
| 2086S0129X | 042000060 | IL | ||
| 208C00000X | Colon & Rectal Surgery | 042000060 | IL |
Practice location
5668 E State StSuite1000
Rockford, IL 61108-2490
Phone 815-397-7900 · Fax 815-397-7919
Mailing address
5668 E State StSuite1000
Rockford, IL 61108-2490
Phone 815-397-7900 · Fax 815-397-7919
Authorized official
Leslie P Edgcomb
President
8153977900
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