INNOVAMED VEINS SC – NPI #1063652873
Internal Medicine

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

INNOVAMED VEINS SC is a provider located in ROCKFORD, IL. NPPES has assigned the NPI number 1063652873 to INNOVAMED VEINS SC on March 06, 2009. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207R00000X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine.

The NPI profile was previously updated about 17 years ago on Jun 04, 2009. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for INNOVAMED VEINS SC below.

NPI Profile for
INNOVAMED VEINS SC

NPI Number
1063652873
Enumeration Date

(more than 17 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
INNOVAMED VEINS SC
Primary location
2601 N MAIN ST
ROCKFORD, IL 61103-3110
Phone: (815) 987-1802 Fax: (815) 987-1806
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
TRACY BRITO
OWNER
Phone: (815) 987-1802
Updated
Identifiers

Identifiers for INNOVAMED VEINS SC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDIL036074111
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207R00000X
- Internal Medicine (Primary)
IL 036074111
202K00000X
- Phlebology
IL 036074111

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.