JACLYN C. WEIDNER (NPI# 1669969275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669969275 |
| Entity Type | Individual |
| Full Name | JACLYN C. WEIDNER |
| Credential | APN |
| Practice Address |
2400 N Rockton Ave Rockford IL 61103-3655 |
| Practice Telephone | 8159715000 |
| Practice Fax Number | 8159715000 |
| Mailing Telephone | 8159715000 |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2018-04-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
209.017495 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| 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 |
| 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 |
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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 |
| Find all providers in zip 61103 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760727010 | Larisa Piton | Nurse Practitioner | 2400 N. Rockton Ave., Pain Management Dept, Rockford, IL 61103-3655 | 2012-11-27 |
| 1346856424 | Keely K Zunker | Nurse Practitioner | 5666 E State St, Rockford, IL 61108-2472 | 2020-09-23 |
| 1497035166 | Lorie Anne Corcoran | Nurse Practitioner | 1401 E State St, 2nd Floor, Rockford, IL 61104-2315 | 2011-08-25 |
| 1295020907 | Sarah Grace Cain | Nurse Practitioner | 2400 N Rockton Ave, Building 2, Suite 310, Rockford, IL 61103-3655 | 2011-06-10 |
| 1568795441 | Denise M Nordenberg | Nurse Practitioner | 5668 E State St, Rockford, IL 61108-2464 | 2009-09-10 |
| 1306030119 | Kathryn Rae Carlovsky | Nurse Practitioner | 5666 E State St, Rockford, IL 61108-2425 | 2007-09-05 |
| 1245300284 | Meredydd Jane Harper | Nurse Practitioner | 535 Roxbury Rd, Rockford, IL 61107-5076 | 2006-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437759461 | Sarah Westerman | Nurse Practitioner | 721 Dover Ct, Pingree Grove, IL 60140-9181 | 2020-10-28 |
| 1609485424 | Intensive Karen LLC | Nurse Practitioner | 612 Mulford St Apt 503, Evanston, IL 60202-3531 | 2020-07-28 |
| 1609484591 | Jennifer Kuczero | Nurse Practitioner | 4059 W 89th Pl, Hometown, IL 60456-1202 | 2020-07-16 |
| 1205452489 | Aneta Trybula | Nurse Practitioner | 10604 W 154th Pl, Orland Park, IL 60462-6025 | 2020-06-23 |
| 1740742170 | Jenna C Reeh | Nurse Practitioner | 1740 W Taylor St # 605e, Chicago, IL 60612-7232 | 2019-04-04 |
| 1588125116 | Sherryl Estorque | Nurse Practitioner | 9033 W Heathwood Cir, Niles, IL 60714-5807 | 2019-03-27 |
| 1992276497 | Laura Beth Miller | Nurse Practitioner | 302 W Hay St Ste 110, Decatur, IL 62526-4167 | 2018-12-09 |
| 1932674322 | Ashleigh M Poptic | Nurse Practitioner | 675 N St Claire St Ste 19-100, Galter Pavilion, Chicago, IL 60611-5969 | 2018-10-11 |
| 1215415039 | Julieanne Ferguson | Nurse Practitioner | 251 E Huron St Dept Of, Chicago, IL 60611-2908 | 2018-08-02 |
| 1275024523 | Lateisha Nicole Fort | Nurse Practitioner | 1222 E 170th St, South Holland, IL 60473-3558 | 2018-05-22 |
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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.