Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.
ROCKFORD PSYCHIATRIC MEDICAL SERVICES, S.C.
Complete NPI Record 1821391442
Psychiatry & Neurology - Psychiatry in Rockford, IL
Active since December 21, 2010
Complete NPI Dataset
This page contains the complete raw NPPES record for Rockford Psychiatric Medical Services, S.c. (NPI 1821391442), a psychiatry & neurology organization in Rockford, IL. All 31 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1821391442 Field 1/31
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 2 Field 2/31
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Employer Identification Number EIN: Not available Field 3/31
- The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
- Provider Organization Name Legal Business Name: ROCKFORD PSYCHIATRIC MEDICAL SERVICES, S.C. Field 4/31
- The name of the organization provider. If the provider is an organization, this is the legal business name.
- Provider First Line Business Mailing Address: 1639 N ALPINE RD STE 260 Field 5/31
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: ROCKFORD Field 6/31
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: IL Field 7/31
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 611071481 Field 8/31
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 9/31
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 6309124241 Field 10/31
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider First Line Business Practice Location Address: 1639 N ALPINE RD STE 260 Field 11/31
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: ROCKFORD Field 12/31
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: IL Field 13/31
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 611071481 Field 14/31
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 15/31
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 8153951500 Field 16/31
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 8153951415 Field 17/31
- The fax number associated with the location address of the provider being identified.
- Authorized Official Last Name: MARRINER Field 20/31
- The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
- Authorized Official First Name: BRANDY Field 21/31
- The first name of the authorized official.
- Authorized Official Middle Name: L Field 22/31
- The middle name of the authorized official.
- Authorized Official Title or Position: CREDENTIALING MANAGER Field 23/31
- The title or position of the authorized official.
- Authorized Official Telephone Number: 6309124241 Field 24/31
- The 10-position telephone number of the authorized official.
- Healthcare Provider Taxonomy Code 1: 2084P0800X Field 25/31
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 1: 036083961 Field 26/31
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 1: IL Field 27/31
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 28/31
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Is Organization Subpart: N Field 29/31
- Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
- Healthcare Provider Taxonomy Group 1: 193400000X SINGLE SPECIALTY GROUP Field 30/31
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Secondary Practice Locations 28
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
N19W24400 Riverwood Dr Ste 350
Location 1/28Waukesha, WI 53188-1182 · Phone (262) 333-3534 · Fax (844) 751-3627
3180 Theodore St Ste 206
Location 2/28Joliet, IL 60435-8524 · Phone (815) 846-6265 · Fax (833) 438-2014
9000 W Chester St Ste 100
Location 3/28Milwaukee, WI 53214-1372 · Phone (414) 296-6189 · Fax (833) 450-5154
1111 Delafield St Ste 213
Location 4/28Waukesha, WI 53188-3403 · Phone (262) 333-3534 · Fax (844) 751-3627
4711 Golf Rd, Ste 1240
Location 5/28Skokie, IL 60076 · Phone (847) 600-9822 · Fax (833) 455-6434
188 W Industrial Dr Ste 236
Location 6/28Elmhurst, IL 60126-1610 · Phone (630) 686-8788
486 W Boughton Rd Ste B
Location 7/28Bolingbrook, IL 60440-2399 · Phone (630) 566-2090 · Fax (833) 646-2087
98 Miller Dr Ste 103
Location 8/28North Aurora, IL 60542-1869 · Phone (630) 566-2721 · Fax (833) 464-4252
100 Fox Glen Ct
Location 9/28Barrington, IL 60010-1805 · Phone (847) 304-0781
1512 Artaius Pkwy Ste 102
Location 10/28Libertyville, IL 60048-5231 · Phone (847) 847-2230
444 N Northwest Hwy Ste 202
Location 11/28Park Ridge, IL 60068-3271 · Phone (847) 692-7101 · Fax (847) 692-7126
2455 Dean St Unit H
Location 12/28St Charles, IL 60175-4830 · Phone (630) 839-9196
9730 S Western Ave Ste 230
Location 13/28Evergreen Park, IL 60805-2760 · Phone (708) 734-9131 · Fax (833) 450-5656
135 N Arlington Heights Rd Ste 105
Location 14/28Buffalo Grove, IL 60089-8215 · Phone (847) 291-8810
1202 W Monroe St Fl 1
Location 15/28Chicago, IL 60607-2509 · Phone (815) 395-1550
2300 Lehigh Ave Ste 215
Location 16/28Glenview, IL 60026-1692 · Phone (847) 621-7700 · Fax (833) 973-4366
342 N Water St Ste 600
Location 17/28Milwaukee, WI 53202-5715 · Phone (414) 296-6189 · Fax (833) 450-5154
1500 W Chicago Ave Unit 2
Location 18/28Chicago, IL 60642-5236 · Phone (773) 570-4220
47 W Acorn Ln
Location 19/28Lake IN The Hills, IL 60156-4804 · Phone (847) 447-6611 · Fax (833) 818-0126
311 S County Farm Rd Ste A
Location 20/28Wheaton, IL 60187-2477 · Phone (630) 517-9233
6319 Fairview Ave Ste 102
Location 21/28Westmont, IL 60559-2889 · Phone (630) 566-2096
233 S 13th St Ste 1100
Location 22/28Lincoln, NE 68508-2003 · Phone (402) 243-5333
74 E 47th st
Location 23/28Chicago, IL 60653-3984 · Phone (312) 300-3149
1639 N Alpine Rd Ste 500
Location 24/28Rockford, IL 61107-1440 · Phone (815) 395-1500 · Fax (833) 656-2718
1608 WESTLAKES PKWY
Location 25/28WEST DES MOINES, IA 50266 · Phone (515) 381-2255
780 Regent St Ste 309
Location 26/28Madison, WI 53715-1233 · Phone (608) 690-5657 · Fax (833) 438-1694
3180 Theodore St Ste 101
Location 27/28Joliet, IL 60435-8520 · Phone (815) 846-6265 · Fax (833) 438-2014
3223 N Sheffield Ave Ste C
Location 28/28Chicago, IL 60657-7231 · Phone (773) 880-2409
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