DR. GILDA DJABARZADE (NPI# 1255890646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255890646 |
| Entity Type | Individual |
| Full Name | DR. GILDA DJABARZADE |
| Credential | M.D. |
| Practice Address |
2400 N Rockton Ave Rockford IL 61103-3655 |
| Mailing Address |
7702 N Alpine Rd Loves Park IL 61111-3107 |
| Practice Telephone | 9518137615 |
| Mailing Telephone | 8159713397 |
| Enumeration Date | 2019-03-15 |
| Last Update Date | 2019-06-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7702 N Alpine Rd, Loves Park, IL 611113107 | 8159713397 |
| Street Address |
2400 N ROCKTON AVE |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61103-3655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457357592 | Michael J Kikta | Surgery | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2005-06-23 |
| 1053950055 | Tina Longphee | Registered Nurse | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2019-12-23 |
| 1598227407 | Shahid Mohammad | Student in an Organized Health Care Education/Training Program | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2019-04-01 |
| 1265993109 | Sarah Elaine Robertson | Student in an Organized Health Care Education/Training Program | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2019-03-25 |
| 1770042525 | Vinita Patel | Student in an Organized Health Care Education/Training Program | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2019-03-19 |
| 1285103002 | Amy Lask | Nurse Practitioner | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2018-11-21 |
| 1477038743 | Michelle Harris | Advanced Practice Midwife | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2018-10-02 |
| 1134603095 | Sarah R Linder | Nurse Practitioner | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2018-09-17 |
| 1376022350 | Atiq Urrehman Khan | Psychiatry & Neurology | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2018-08-09 |
| 1023508769 | Stephanie Birmingham | Internal Medicine | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2018-05-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598398497 | The Elitist Group | Home Health Aide | 2929 N Main Street, Rockford, IL 61103 | 2020-02-19 |
| 1972064194 | Mahita Bellamkonda | Student in an Organized Health Care Education/Training Program | 2400 North Rockton Avenue, Rockford, IL 61103 | 2019-03-29 |
| 1558538967 | Willows Health Center | Clinic/Center | 4143 Albright Lane, Rockford, IL 61103 | 2008-05-14 |
| 1497845135 | Humaira Bari | Internal Medicine | 2400 N. Rockton Avenue, Rockford, IL 61103 | 2006-10-13 |
| 1841385242 | Rachel Pawlowski | Occupational Therapist | 3616 N. Main Street, Rockford, IL 61103 | 2006-10-03 |
| 1417068438 | Alicia Anne Huntley | Midwife | 2400 Rockton Ave, Rockford, IL 61103 | 2006-08-31 |
| 1639190200 | Glendon Burress | Pediatrics | 2300 N. Rockton Ave., Rockford Health Physicians, Rockford, IL 61103 | 2006-07-21 |
| 1225065204 | Daniel William Johnson | Dentist | 519 Toner Av, Rockford, IL 61103 | 2006-06-27 |
| 1760472898 | Ronald Peter Oberfoell | Anesthesiology | 2400 North Rockton Ave, Rockford Health Physicians, Rockford, IL 61103 | 2005-10-28 |
| 1841752532 | Dipti Sabharwal | Student in an Organized Health Care Education/Training Program | 2400 N Rockton Avenue, Rockford, IL 61103 | 2019-04-02 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871118174 | Dalton Menke | Student in an Organized Health Care Education/Training Program | 707 Woodsong Ct, Rockford, IL 61102-5625 | 2020-06-11 |
| 1881216729 | Dylan Jackson Dick | Student in an Organized Health Care Education/Training Program | 226 Glenview Ct Ne, Rockford, MI 49341-1198 | 2020-05-14 |
| 1366064560 | Caleb Ifeoluwa Oluwadamisi | Student in an Organized Health Care Education/Training Program | Mercy Health Javon Bea Hospital, 8201 East Riverside Boulevard, Rockford, IL 61114 | 2020-05-11 |
| 1457980138 | Alexandria Conner | Student in an Organized Health Care Education/Training Program | 9501 Sunset Ridge Dr Ne, Rockford, MI 49341-7116 | 2020-04-05 |
| 1679109789 | Alyssa Tunison | Student in an Organized Health Care Education/Training Program | 1722 Huffman Blvd, Rockford, IL 61103-4531 | 2020-03-20 |
| 1497380224 | Michael Magnuson | Student in an Organized Health Care Education/Training Program | 5268 Deer Pointe, Rockford, IL 61114-7068 | 2020-03-12 |
| 1467092379 | Unknown Safa Fatima | Student in an Organized Health Care Education/Training Program | Mercyhealth Mulford Clinic, 5970 Churchview Drive, Rockford, IL 61107 | 2020-01-08 |
| 1154980076 | Anurag Gill | Student in an Organized Health Care Education/Training Program | 8201 East Riverside Boulevard, Mercy Health Javon Bea Hospital, Rockford, IL 61114 | 2019-06-13 |
| 1578121943 | Sona Najafi | Student in an Organized Health Care Education/Training Program | Mercyhealth Javon Bea Hospital, 8201 East Riverside Blvd, Rockford, IL 61114 | 2019-05-31 |
| 1578127007 | Jose Luis Gallardo | Student in an Organized Health Care Education/Training Program | 2133 Oxford St, Rockford, IL 61103-4160 | 2019-04-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.