MYS - ROCKFORD LLC (NPI# 1952771636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952771636 |
| Entity Type | Organization |
| Organization Name | MYS - ROCKFORD LLC |
| Practice Address |
1110 S Mulford Rd Rockford IL 61108-4213 |
| Practice Telephone | 8153983879 |
| Mailing Telephone | 8153983879 |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2017-06-19 |
| Authorized Official Name | TODD STERN (OWNER) |
| Authorized Official Telephone | 8153982879 |
| Authorized Official Credential | D.D.S |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
019028820 | IL | Dental Providers |
| N | 261QD0000X |
Clinic/Center Specialization: Dental |
019021620 | IL | Ambulatory Health Care Facilities |
| N | 261QD0000X |
Clinic/Center Specialization: Dental |
019030473 | IL | Ambulatory Health Care Facilities |
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
019024307 | IL | Ambulatory Health Care Facilities |
| Street Address |
1110 S MULFORD RD |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61108-4213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225257421 | Todd Duane Stern | Dentist | 1110 S Mulford Rd, Rockford, IL 61108-4213 | 2007-04-25 |
| 1336679786 | Marshall Valadez | Dentist | 1110 S Mulford Rd, Rockford, IL 61108-4213 | 2017-06-19 |
| 1073988796 | Gabrielle Chevance | Dentist | 1110 S Mulford Rd, Rockford, IL 61108-4213 | 2015-12-07 |
| 1043525710 | Donald J Kyle | Dentist | 1110 S Mulford Rd, Rockford, IL 61108-4213 | 2010-08-18 |
| 1992919831 | John Edward Halversen Jr. | Dentist | 1110 S Mulford Rd, Rockford, IL 61108-4213 | 2007-05-10 |
| 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 | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841616661 | Ideal Dental Care PC | Clinic/Center | 5876 E State St, Rockford, IL 61108-2428 | 2014-03-18 |
| 1669094041 | Cherryvale Dental Center LLC | Clinic/Center | 1957 Pawlisch Dr, Rockford, IL 61112-1067 | 2020-05-08 |
| 1932666922 | Robert Busan Dds, Pllc | Clinic/Center | 4035 Morsay Dr Ste 1, Rockford, IL 61107-4875 | 2019-02-26 |
| 1730676990 | Alex Moore, Dmd PC | Clinic/Center | 6050 Brynwood Dr Ste 205, Rockford, IL 61114 | 2018-04-13 |
| 1689824898 | Corey J Brenner Dds Pllc | Clinic/Center | 9000 Walnut St, Box 236, Rockford, MN 55373-0236 | 2008-09-24 |
| 1639202914 | Thomas H. Moore Dds Ltd | Clinic/Center | 6075 Vantage Pl, Rockford, IL 61107-5905 | 2007-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124629514 | Chicago Pediatric Dentistry and Orthodontics | Clinic/Center | 1136 S Delano Ct W Ste B202, Chicago, IL 60605-3734 | 2020-11-03 |
| 1437750031 | Secure Dental Xi | Clinic/Center | 1843 W Golf Rd, Schaumburg, IL 60194-1148 | 2020-11-02 |
| 1780283267 | Jenna Gaw, Dds, Pllc | Clinic/Center | 1724 Locust Pl Apt 303, Schaumburg, IL 60173-4239 | 2020-10-26 |
| 1740889344 | Nsp Dental LLC | Clinic/Center | 1900 Hollister Dr Ste 190, Libertyville, IL 60048-5283 | 2020-10-23 |
| 1285232827 | Paul Doodes Dds Phd PC | Clinic/Center | 45 S Park Blvd Ste 190, Glen Ellyn, IL 60137-6282 | 2020-10-15 |
| 1780290676 | Great Smile Dental Pllc | Clinic/Center | 720 Osterman Ave Ste 304, Deerfield, IL 60015-4339 | 2020-09-16 |
| 1669087375 | Naperville Smiles Dental | Clinic/Center | 8 W Gartner Rd Ste 124, Naperville, IL 60540-7549 | 2020-09-09 |
| 1649883364 | Mark J Maly Estate | Clinic/Center | 103 S Main St # Po, Orangeville, IL 61060-9244 | 2020-08-24 |
| 1760094718 | Stoffel and Tomazin Dental Associates, Ltd | Clinic/Center | 5718 W 35th St, Cicero, IL 60804-4222 | 2020-08-20 |
| 1215548771 | Meda Dental II LLC | Clinic/Center | 2735 Hassert Blvd Ste 159, Naperville, IL 60564-5205 | 2020-08-10 |
| 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.