Provider Demographics
NPI:1285925081
Name:ROCKFORD NAR, LLC
Entity type:Organization
Organization Name:ROCKFORD NAR, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ATTORNEY
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:MEEHAN
Authorized Official - Suffix:
Authorized Official - Credentials:ESQ
Authorized Official - Phone:312-521-2467
Mailing Address - Street 1:1920 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61103-4708
Mailing Address - Country:US
Mailing Address - Phone:815-316-1400
Mailing Address - Fax:815-968-6795
Practice Address - Street 1:1920 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61103-4708
Practice Address - Country:US
Practice Address - Phone:815-316-1400
Practice Address - Fax:815-968-6795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL145919Medicare UPIN