GRAND VICTORIAN OF ROCKFORD, LLC (NPI# 1891991550) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891991550 |
| Entity Type | Organization |
| Organization Name | GRAND VICTORIAN OF ROCKFORD, LLC |
| Practice Address |
3495 Mcfarland Rd Rockford IL 61114-5609 |
| Mailing Address |
78 Centennial Loop Eugene OR 97401-7900 |
| Practice Telephone | 8156541400 |
| Practice Fax Number | 8156541488 |
| Mailing Telephone | 5417473373 |
| Mailing Fax Number | 5417470673 |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2008-05-13 |
| Authorized Official Name | MR. JOHN HOLTZ (CONTROLLER) |
| Authorized Official Telephone | 5417473373 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305S00000X | Point of Service | Managed Care Organizations |
| Street Address |
3495 MCFARLAND RD |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61114-5609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366064560 | Caleb Ifeoluwa Oluwadamisi | Student in an Organized Health Care Education/Training Program | Mercy Health Javon Bea Hospital, 8201 East Riverside Boulevard, Rockford, IL 61114 | 2020-05-11 |
| 1811525959 | Seifeldin Eid | Student in an Organized Health Care Education/Training Program | Mercyhealthjavon Bea Hospital, 8201, East Riversideboulevard, IL 61114 | 2020-04-01 |
| 1073167664 | Swedishamerican Hospital | Internal Medicine | 3505 N Bell School Road, Rockford, IL 61114 | 2019-07-31 |
| 1154980076 | Anurag Gill | Student in an Organized Health Care Education/Training Program | 8201 East Riverside Boulevard, Mercy Health Javon Bea Hospital, Rockford, IL 61114 | 2019-06-13 |
| 1578121943 | Sona Najafi | Student in an Organized Health Care Education/Training Program | Mercyhealth Javon Bea Hospital, 8201 East Riverside Blvd, Rockford, IL 61114 | 2019-05-31 |
| 1760045744 | Julianna Jones | Counselor | 6653 Weaver Rd Ste 115, Rockford, IL 61114 | 2019-04-16 |
| 1952869943 | Angela Marie Hawkins | Nurse Practitioner | 8201 E. Riverside Blvd, Pediatric Neurology, Rockford, IL 61114 | 2019-03-08 |
| 1376029231 | Meghan Beth Teske | Chiropractor | 3779 N. Alpine Rd., Rockfod, IL 61114 | 2018-07-13 |
| 1811401284 | Summit Radiology, LLC | Clinic/Center | 3849 N. Perryville Road, Rockford, IL 61114 | 2017-11-21 |
| 1548704299 | Rockford Orthopedic Associates, Ltd | Durable Medical Equipment & Medical Supplies | 5929 E Riverside Blvd, Rockford, IL 61114 | 2016-12-15 |
| Find all providers in zip 61114 | ||||
| Taxonomy Code | 305S00000X |
| Grouping | Managed Care Organizations |
| Classification | Point of Service |
| This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 62 |
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|---|---|---|---|---|
| 1083905467 | International Dental Center | Point of Service | 3502 E State St, Rockford, IL 61108-1914 | 2011-04-20 |
| 1043548563 | River District Rehabilitation, LLC | Point of Service | 119 N Wyman St, Rockford, IL 61101-1107 | 2009-11-20 |
| 1730458878 | Global Dental Center Inc | Point of Service | 3502 E State St, Rockford, IL 61108-1914 | 2011-12-19 |
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| 1033590427 | Interstate Phlebotomy Services Inc | Point of Service | 3200 Drover Ln, Darien, IL 60561-1642 | 2015-06-11 |
| 1699182642 | In Home Counseling for Seniors | Point of Service | 2318 N Lowell Ave, Chicago, IL 60639-3520 | 2014-07-22 |
| 1972934610 | Center for Vitality and Balance, LLC | Point of Service | 1280 Iroquois Ave Ste 404, Naperville, IL 60563-8570 | 2013-12-05 |
| 1720419732 | The Excellence Group, LLC | Point of Service | 1102 E 46th St Unit 202, Chicago, IL 60653-4435 | 2013-12-02 |
| 1457781916 | Applied Behavior Interventions | Point of Service | 219 N Oak Park Ave, Oak Park, IL 60302-2151 | 2013-11-20 |
| Find all providers with the same taxonomy | ||||
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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.