MACKENZIE T WORTHINGTON


Address: 2404 Charles St, Rockford, IL 61108
Phone: 7796967910

MACKENZIE T WORTHINGTON (NPI# 1467893461) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1467893461
Entity Type Individual
Full Name MACKENZIE T WORTHINGTON
Credential DO
Practice Address 2404 Charles St
Rockford
IL 61108
Mailing Address Po Box 78866
Milwaukee
WI 53278-8866
Practice Telephone 7796967910
Practice Fax Number 7796967918
Mailing Telephone 7796967150
Enumeration Date 2013-07-08
Last Update Date 2018-07-23
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine 036144076 IL Allopathic & Osteopathic Physicians
N 207Q00000X Family Medicine R9738 IA Allopathic & Osteopathic Physicians

Office Location

Street Address 2404 CHARLES ST
City ROCKFORD
State IL
Zip Code 61108

Providers in the same location

NPI Name Taxonomy Address Enumeration
1972552131 Andrea B Fulcomer Physician Assistant 2404 Charles St, Rockford, IL 61108-1602 2006-05-08
1144784026 Laura L Huszla Nurse Practitioner 2404 Charles St, Rockford, IL 61108-1602 2019-01-25
1942741970 Anna Nielsen Dietitian, Registered 2404 Charles St, Rockford, IL 61108-1602 2017-03-09
1598179491 Marden E Torrijos Family Medicine 2404 Charles St, Rockford, IL 61108-1602 2014-06-18
1821283565 Snigdha Volety Family Medicine 2404 Charles St, Rockford, IL 61108 2007-09-06
1275732091 Gurpreet Kaur Boparai Family Medicine 2404 Charles St, Rockford, IL 61108 2007-07-12
1093827115 Swedishamerican Hospital Nurse Practitioner 2404 Charles St, Rockford, IL 61108 2006-08-31
1538199666 Beth A Christiansen Nurse Practitioner 2404 Charles St, Rockford, IL 61108 2006-07-04
1275562712 Richard E Deming Family Medicine 2404 Charles St, Rockford, IL 61108-1602 2006-06-30
1780613273 Leynard M Martinez Family Medicine 2404 Charles St, Rockford, IL 61108 2006-06-30
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1952862617 Isr Enterprises, Inc. Homemaker 129 Phelps Ave, Bldg 10, Ste 1008, Rockford, IL 61108 2019-03-26
1003306465 Adrienne Nicole Black Behavior Technician 519 Woodland Dr, Woodland Dr, Rockford, IL 61108 2018-05-11
1184085201 Integrative Healing Center, LLC Clinic/Center 6019 Fincham Drive, Rockford, IL 61108 2016-03-17
1730547936 Perryville Dentist PC Dentist 845 S Perryville Rd, Unit 119, Rockford, IL 61108 2016-02-02
1023489853 Nicole Ping Ticknor Counselor 433 S. Phelps Ave., Suite 2, Rockford, IL 61108 2015-10-20
1275940348 Northwest Home Care, Inc. Home Health 1437 S. Bell School Road, Suite 7, Rockford, IL 61108 2014-07-21
1487072922 Alecia Greenlee Psychiatry & Neurology Rosecrance Community Mental Health, 3815 Harrison Avenue, Rockford, IL 61108 2014-04-02
1871925446 Maria Laura Gustafson Interpreter 3208 Wesleyan Ave., Rockford, IL 61108 2013-08-06
1346582822 Joseph Peevey Pathology 5666 E State Street, Department of Pathology, Rockford, IL 61108 2013-03-21
1134466923 James Henry Peck Hearing Instrument Specialist 2424 Charles St, Rockford, IL 61108 2013-01-14
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Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
- Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
- Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1851910350 Charity L Soles Family Medicine 4134 Ashwinton Way, Rockford, IL 61109-3273 2020-04-14
1306250543 Camille Ryan Family Medicine 6050 Northland Dr Ne Ste 200, Rockford, MI 49341-9257 2014-06-16
1396991485 Novella Ann Schafer Family Medicine 3719 Regal Ridge Circle, Rockford, IL 61114-6037 2008-08-08
1417139130 Derek Lanier Family Medicine 8450 Brower Lake Rd Ne, Apt/suite, Rockford, MI 49341-9346 2007-12-04
1144414921 Moses Godofredo Tomacruz Family Medicine 1502 Parkview Ave, Rockford, IL 61107-1821 2007-09-05
1508077165 Robert Dejonge Do PC Family Medicine 350 Northland Dr Ne, Rockford, MI 49341-1401 2007-05-25
1902018641 Julie Stark Family Medicine 3475 So Alpine Rd, Physicians Immediate Care, Rockford, IL 61109-2604 2007-05-04
1205976024 Mohammed Khaleeluddin Family Medicine 1729 Oak Park Drive, Rockford, IL 61107-5510 2007-02-08
1134273238 Swedishamerican Hosptial Family Medicine 3906 N Main St, Suite A, Rockford, IL 61103-1679 2007-01-23
1194897223 Niccole Ranz Family Medicine 2222 E State St, Suite 209, Rockford, IL 61104-1573 2006-11-14
Find all providers in ROCKFORD

Competitor

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City ROCKFORD
Zip Code 61108

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Dataset Information

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.

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