DR. FIKISHA LATOYA WARDEN (NPI# 1679701395) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679701395 |
| Entity Type | Individual |
| Full Name | DR. FIKISHA LATOYA WARDEN |
| Credential | M.D. |
| Practice Address |
4857 Manhattan Dr Rockford IL 61108 |
| Mailing Address |
4857 Manhattan Dr Rockford IL 61108-2265 |
| Practice Telephone | 8157080116 |
| Practice Fax Number | 8157080174 |
| Mailing Telephone | 8157080116 |
| Mailing Fax Number | 8157080174 |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2020-06-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 036144365 | IL | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 2014024079 | MO | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 50745 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | IDFPR | 036144365 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1011 Bowles Ave, Suite 300, Fenton, MO 630262395 | 6364965000 | 6364965055 |
| Street Address |
4857 MANHATTAN DR |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770698508 | Nelson P Gurney | Ophthalmology | 4857 Manhattan Dr, Rockford, IL 61108-2265 | 2006-08-20 |
| 1568025872 | Hopkins Family Med & Urgent Care, Pllc | Family Medicine | 4857 Manhattan Dr, Rockford, IL 61108-2265 | 2019-04-22 |
| 1538404827 | Malik Eye Institute LLC | Ophthalmology | 4857 Manhattan Dr, Rockford, IL 61108-2265 | 2012-11-28 |
| 1447595780 | Malik Eye Institute LLC | Eyewear Supplier (Equipment, not the service) | 4857 Manhattan Dr, Rockford, IL 61108-2265 | 2012-11-27 |
| 1518105121 | Imler Vision Centers, LLC | Eyewear Supplier (Equipment, not the service) | 4857 Manhattan Dr, Rockford, IL 61108-2265 | 2009-02-04 |
| 1396914495 | Imler Eye Clinic of Rockford, LLC | Specialist | 4857 Manhattan Dr, Rockford, IL 61108-2265 | 2008-02-22 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| 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 | ||||
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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.