DEREK TIMMERMANN (NPI# 1649213141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649213141 |
| Entity Type | Individual |
| Full Name | DEREK TIMMERMANN |
| Credential | M.D. |
| Practice Address |
5666 E State St Emergency Department Rockford IL 61108-2425 |
| Mailing Address |
5666 E State St Rockford IL 61108-2425 |
| Practice Telephone | 8153955189 |
| Mailing Telephone | 8153955189 |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2012-08-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 036.118970 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | WA91176B | 05 |
| Street Address |
5666 E STATE ST EMERGENCY DEPARTMENT |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61108-2425 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508849209 | Richard Emery Freeman | Neurological Surgery | 5666 E State St, Rockford, IL 61108-2425 | 2005-11-28 |
| 1881293348 | Salman Nafees | Nurse Anesthetist, Certified Registered | 5666 E State St, Rockford, IL 61108-2425 | 2020-10-25 |
| 1346856424 | Keely K Zunker | Nurse Practitioner | 5666 E State St, Rockford, IL 61108-2472 | 2020-09-23 |
| 1962026476 | Angie Youssef Hernandez | Student in an Organized Health Care Education/Training Program | 5666 E State St, Rockford, IL 61108-2425 | 2020-06-01 |
| 1568085710 | Kelsey Surowiec | Student in an Organized Health Care Education/Training Program | 5666 E State St, Rockford, IL 61108-2425 | 2020-05-22 |
| 1801415864 | Kyle R Clark | Physician Assistant | 5666 E State St, Rockford, IL 61108-2425 | 2020-04-10 |
| 1508495144 | Sadie Jae Pierce-mulligan | 5666 E State St, Rockford, IL 61108-2425 | 2020-04-06 | |
| 1376170183 | Nicole Ann O'neill | Dietitian, Registered | 5666 E State St, Rockford, IL 61108-2425 | 2020-03-24 |
| 1447884804 | Marissa Ann Giannangeli | Occupational Therapist | 5666 E State St, Rockford, IL 61108-2425 | 2020-02-25 |
| 1023659711 | Erin R. Moody | Physician Assistant | 5666 E State St, Rockford, IL 61108-2425 | 2019-10-03 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 61108 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518128255 | Virginia Ann Stoll-tyrrell | Emergency Medicine | 1401 East State Street, Rockford, IL 61104-2315 | 2008-06-24 |
| 1871621144 | Robert Charles Porter | Emergency Medicine | 605 Fulton Ave, Suite 2002, Rockford, IL 61103-4179 | 2007-03-01 |
| 1205890605 | Daniel B Cunningham | Emergency Medicine | 4685 Belding Rd Ne, Rockford, MI 49341-9605 | 2006-04-13 |
| 1043280811 | Christopher M. Nielsen | Emergency Medicine | 5666 East State Street, Rockford, IL 61108-2425 | 2006-01-25 |
| 1326037029 | Pervaz M. Choudry | Emergency Medicine | 5266 Thornberry Dr, Rockford, IL 61114-6395 | 2005-10-17 |
| 1184232621 | Sound Physicians Emergency Medicine of Illinois LLC | Emergency Medicine | 1401 E State St, Rockford, IL 61104-2315 | 2020-07-21 |
| 1538790266 | Sherri L Paprocki | Emergency Medicine | 1401 E State St, Rockford, IL 61104-2315 | 2020-01-31 |
| 1891223285 | Kathryn R Johns | Emergency Medicine | 2400 N Rockton Ave, Rockford, IL 61103-3655 | 2017-05-30 |
| 1639602543 | Muhammad Muaz Shareef | Emergency Medicine | 1401 E State St, Rockford, IL 61104-2315 | 2017-04-07 |
| 1710341987 | Sonia Khan | Emergency Medicine | 1401 E State St, Rockford, IL 61104-2315 | 2016-04-13 |
| 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.