CORA MARIE REYNOLDS (NPI# 1639586399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639586399 |
| Entity Type | Individual |
| Full Name | CORA MARIE REYNOLDS |
| Credential | ANP-BC |
| Practice Address |
301 E State St Rockford IL 61104-1012 |
| Mailing Address |
213 N Racine Ave Ste. 100 Chicago IL 60607-1644 |
| Practice Telephone | 8156687810 |
| Practice Fax Number | 8157146219 |
| Mailing Telephone | 3127339730 |
| Mailing Fax Number | 7738668014 |
| Enumeration Date | 2014-07-15 |
| Last Update Date | 2016-08-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
209.011587 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | STATE RN | 041.416257 | 01 |
| Street Address |
301 E STATE ST |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61104-1012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053364349 | Carlos Aguero-medina | Family Medicine | 301 E State St, Rockford, IL 61104-1012 | 2006-05-18 |
| 1053889774 | Laken J Sisson | Social Worker | 301 E State St, Rockford, IL 61104-1012 | 2018-11-12 |
| 1508342874 | Alissa Haight | Counselor | 301 E State St, Rockford, IL 61104-1012 | 2018-07-19 |
| 1174017982 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 301 E State St, Rockford, IL 61104-1012 | 2018-06-15 |
| 1487171328 | Jessika Marie Epperson | Nurse Practitioner | 301 E State St, Rockford, IL 61104-1012 | 2017-08-22 |
| 1497911267 | Babatunde Idowu Ogundipe | Psychiatry & Neurology | 301 E State St, Rockford, IL 61104-1012 | 2008-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699216564 | Swedishamerican Hospital | Nutritionist | 1415 E. State St., Lower Level A3, Rockford, IL 61104 | 2017-03-13 |
| 1376950485 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 200, Rockford, IL 61104 | 2014-07-21 |
| 1871907774 | Oday Alsarraf | Psychiatry & Neurology | 1401 E State Street, Center for Mental Health, Swedish American Hospital, Rockford, IL 61104 | 2014-06-18 |
| 1962652339 | Children's Home and Aid | Community/Behavioral Health | 424 7th St, Rockford, IL 61104 | 2008-09-23 |
| 1689729535 | Swedishamerican Hospital | Nurse Practitioner | 1340 Charles St Ste 100, Rockford, IL 61104 | 2007-01-23 |
| 1790873016 | David J Schleicher | Obstetrics & Gynecology | 209 9th St Ste 200, Rockford, IL 61104 | 2006-10-11 |
| 1013026624 | Thomas Ryan Moss | Dentist | 1415 E State Street, Rockford, IL 61104 | 2006-08-29 |
| 1366452096 | Arturo Santiago Manas | Obstetrics & Gynecology | 1415 E State St Fl 8, Rockford, IL 61104 | 2006-08-08 |
| 1245263268 | William John Stout | Physician Assistant | 1401 E State Street, Rockford, IL 61104 | 2006-07-10 |
| 1689604969 | Prabha Chand Dosi | Pediatrics | 1401 E. State Street, Rockford, IL 61104 | 2006-07-03 |
| Find all providers in zip 61104 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275004087 | Ruth Taggart, LLC | Nurse Practitioner | 719 Paris Ave, Rockford, IL 61107-3241 | 2018-12-06 |
| 1255980025 | Jeffrey Boyd | Nurse Practitioner | 1200 W State St, Rockford, IL 61102-2112 | 2019-09-05 |
| 1700338720 | Fiona Uzoamaka Okoroti | Nurse Practitioner | 3650 N Alpine Rd, Rockford, IL 61114-4899 | 2016-10-25 |
| 1396158812 | Melissa House | Nurse Practitioner | 2300 N Rockton Ave, Rockford, IL 61103-3619 | 2014-06-03 |
| 1073941605 | Angela Marie Hadie | Nurse Practitioner | 1200 W State St, Rockford, IL 61102-2112 | 2013-10-16 |
| 1205261724 | Michelle Lee Cleveland | Nurse Practitioner | 3401 N Perryville Rd, Suite 303, Rockford, IL 61114-8011 | 2013-09-04 |
| 1992057251 | Anne M Celner | Nurse Practitioner | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2012-10-11 |
| 1801121405 | Christine L. Valentine | Nurse Practitioner | 1340 Charles St Ste 300, Rockford, IL 61104-2200 | 2009-10-15 |
| 1053554493 | Angela Brown | Nurse Practitioner | 5911 Nebeshone Ln, Rockford, IL 61103-8926 | 2009-04-15 |
| 1407039167 | Michele Dawn Johnson | Nurse Practitioner | 3775 N Mulford Rd, Rockford, IL 61114-5632 | 2007-12-17 |
| Find all providers in ROCKFORD | ||||
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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.