Rockford Dermatology Sc
LBN: Rockford Dermatology Sc
Rockford Dermatology Sc is an health care organization with primary practice located at 4338 Morsay Dr , Rockford IL 61107-4877. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Procedural Dermatology. Allopathic & Osteopathic Physicians / Dermatology is the primary health care specialty.
Rockford Dermatology Sc can be contacted via phone (815) 399-6400, or through Coates, Lakimerly Michelle via phone (815) 399-6400.
Contact Information
Primary practice address
4338 Morsay Dr
Rockford IL 61107-4877
Phone: (815) 399-6400
Fax: (815) 399-4424
Website:
Authorized official contact:
Name: Coates, Lakimerly Michelle Doctor of Medicine (MD)
Phone: (815) 399-6400
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 042617821 | Illinois |
| Allopathic & Osteopathic Physicians / Procedural Dermatology | 207NS0135X | 042617821 | Illinois |
Profile Details
| NPI number | 1487751335 |
|---|---|
| LBN Legal business name | Rockford Dermatology Sc |
| DBA Doing business as | |
| Authorized official | Coates, Lakimerly Michelle Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Feb 19th, 2018 - about 6 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487751335 | NPPES |
| Illinois | MEDICAID | 036102903 | |
| Illinois | Other | 7847308 | |
| Illinois | Other | 203521 | |
| Illinois | Other | 10132043 |
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