Affiliated Surgeons Of Rockford LLC

Surgery in Rockford, IL. Organization (NPI-2).

NPI number1851394696

StatusActive

Last updated in NPPESFeb 17, 2012

Details

NPI: 1851394696
Entity type: Organization (NPI-2)
Legal business name: Affiliated Surgeons Of Rockford LLC
Organization subpart: No
Enumeration date: May 24, 2005
Last updated: Feb 17, 2012

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
208600000X	Surgery	036062833	IL	Yes
2085R0204X	Radiology, Vascular & Interventional Radiology	036104533	IL
2086S0129X		036063647	IL
208C00000X	Colon & Rectal Surgery	036064410	IL
208600000X	Surgery	036048085	IL
2086S0129X		036101179	IL
2086S0129X		036067268	IL
208600000X	Surgery	036064323	IL
363AS0400X	Physician Assistant, Surgical	085002211	IL
363L00000X	Nurse Practitioner	209004303	IL
2086S0122X	Surgery, Plastic and Reconstructive Surgery	036071666	IL

Practice location

2300 N Rockton Ave
Ste 304
Rockford, IL 61103-3619

Phone 815-964-3333 · Fax 815-964-3134

Mailing address

Po Box 15730
Loves Park, IL 61132-5730

Phone 815-964-3333 · Fax 815-964-3134

Authorized official

Paul J Klazura
Controlling Partner
8154896034

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