DR. MICHAEL J KIKTA (NPI# 1457357592) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457357592 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL J KIKTA |
| Credential | M.D. |
| Practice Address |
2400 N Rockton Ave Rockford IL 61103-3655 |
| Mailing Address |
7974 Uw Health Ct Middleton WI 53562-5531 |
| Practice Telephone | 8159715000 |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2018-10-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2086S0127X |
Surgery Specialization: Trauma Surgery |
036067268 | IL | Allopathic & Osteopathic Physicians |
| N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
66280 | WI | Allopathic & Osteopathic Physicians |
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
036067268 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036067268 2 | 05 | |
| IL | PERSONAL CARE | 194341 | 01 |
| IL | OWCP | 204575400 | 01 |
| Street Address |
2400 N ROCKTON AVE |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61103-3655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1255890646 | Gilda Djabarzade | Student in an Organized Health Care Education/Training Program | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2019-03-15 |
| 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 | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851394696 | Affiliated Surgeons of Rockford LLC | Surgery | 2300 N Rockton Ave, Ste 304, Rockford, IL 61103-3619 | 2005-05-24 |
| 1346468105 | Heather Anne Hall | Surgery | 2350 N Rockton Ave, Rockford, IL 61103-3600 | 2007-04-24 |
| 1548386998 | Swedishamerican Hospital | Surgery | 2300 N Rockton Ave, Rockford, IL 61103-3619 | 2007-03-21 |
| 1629014022 | Leslie Paul Edgcomb | Surgery | 5668 E State St, Rockford, IL 61108-2464 | 2006-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396267324 | Congress Vascular Center LLC | Surgery | 41 W Congress Pkwy Fl 1, Chicago, IL 60605-1531 | 2017-07-11 |
| 1043731300 | Elmwood Park Vascular Center LLC | Surgery | 7230 W North Ave Ste 108, Elmwood Park, IL 60707-4261 | 2017-06-27 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1992126668 | Vascular Specialists LLC | Surgery | 20060 Governors Dr Ste 102, Olympia Fields, IL 60461-1099 | 2013-12-26 |
| 1588959548 | Patrick Michael Sullivan Neville | Surgery | 4600 Memorial Dr Ste 120, Belleville, IL 62226-5359 | 2011-06-17 |
| 1235454968 | Margaret Claire Rigamer | Surgery | 1901 W Harrison St Dept Of, Chicago, IL 60612-3714 | 2010-04-06 |
| 1215251541 | John V. White, Md, LLC | Surgery | 8816 W Dempster St, Niles, IL 60714-5109 | 2010-03-15 |
| 1710212733 | Vascular Surgery and Interpretation S.c. | Surgery | 3330 W 177th St Ste 2c1, Hazel Crest, IL 60429-2184 | 2009-10-08 |
| 1538391792 | Usa Vein Clinics of Chicago LLC | Surgery | 4141 Dundee Rd, Northbrook, IL 60062-2129 | 2009-08-20 |
| 1306010731 | Tanq, Inc. | Surgery | 18510 S Marilynn Ct, Mokena, IL 60448-9517 | 2008-04-16 |
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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.