| Rosecrance Inc | |
|
1021 N Mulford Rd Rockford IL 61107-3877 | |
| (815) 391-1000 | |
| (815) 316-4726 |
| Full Name | Rosecrance Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1021 N Mulford Rd, Rockford, Illinois |
| Authorized Official Name and Position | Philip W Eaton (PRESIDENT / CEO) |
| Authorized Official Contact | 8153911000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rosecrance Inc 1021 N Mulford Rd Rockford IL 61107-3877 Ph: (815) 391-1000 | Rosecrance Inc 1021 N Mulford Rd Rockford IL 61107-3877 Ph: (815) 391-1000 |
| NPI Number | 1013289446 |
|---|---|
| Provider Enumeration Date | 02/01/2012 |
| Last Update Date | 05/21/2013 |
| Medicare PECOS PAC ID | 3779656582 |
|---|---|
| Medicare Enrollment ID | O20130502000371 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013289446 | NPI | - | NPPES |
| Provider Name | Richard Jaconette |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578785432 PECOS PAC ID: 3971408915 Enrollment ID: I20031203000630 |
| Provider Name | Alvydas J Baris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821029091 PECOS PAC ID: 7012800444 Enrollment ID: I20040207000258 |
| Provider Name | Reginald A Givens |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568533701 PECOS PAC ID: 5597655316 Enrollment ID: I20040317000046 |
| Provider Name | Adrienne L Adams |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578661781 PECOS PAC ID: 9830186741 Enrollment ID: I20040430000368 |
| Provider Name | Mehtab Mizan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104976380 PECOS PAC ID: 8123003548 Enrollment ID: I20040621001052 |
| Provider Name | Carrie L Sharkey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295725323 PECOS PAC ID: 1153394556 Enrollment ID: I20040813001257 |
| Provider Name | Carol J Claxon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487927372 PECOS PAC ID: 3577536465 Enrollment ID: I20040818000754 |
| Provider Name | Therese M Lucietto-sieradzki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699708636 PECOS PAC ID: 5395706774 Enrollment ID: I20041019001296 |
| Provider Name | Kathleen A Kessler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396808390 PECOS PAC ID: 1355381765 Enrollment ID: I20050505000149 |
| Provider Name | Desiree A Rahman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871679522 PECOS PAC ID: 3971549718 Enrollment ID: I20050701000717 |
| Provider Name | Narain D Mandhan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730170655 PECOS PAC ID: 7517852767 Enrollment ID: I20051228000257 |
| Provider Name | Michael A Kuna |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1750345872 PECOS PAC ID: 3072587682 Enrollment ID: I20060207000082 |
| Provider Name | Shahina H Jafry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053383737 PECOS PAC ID: 8729097829 Enrollment ID: I20060418000712 |
| Provider Name | Dennis R Brightwell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841288420 PECOS PAC ID: 4981615028 Enrollment ID: I20060605000250 |
| Provider Name | Uma Srivastava |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194815290 PECOS PAC ID: 9537253729 Enrollment ID: I20070919000280 |
| Provider Name | Gail Y Brick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679724561 PECOS PAC ID: 0840353603 Enrollment ID: I20090106000434 |
| Provider Name | John D Benton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639358039 PECOS PAC ID: 3072679729 Enrollment ID: I20090304000235 |
| Provider Name | Linda S Culton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639250848 PECOS PAC ID: 9537209143 Enrollment ID: I20091211000539 |
| Provider Name | Chandragupta Vedak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871592881 PECOS PAC ID: 0244305233 Enrollment ID: I20101026000754 |
| Provider Name | Evan C Silvi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891988010 PECOS PAC ID: 6507052412 Enrollment ID: I20101117001593 |
| Provider Name | Joseph M Neubauer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801896329 PECOS PAC ID: 8022168137 Enrollment ID: I20101122001143 |
| Provider Name | Jorge E Fernald |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912056326 PECOS PAC ID: 5698962165 Enrollment ID: I20101209000544 |
| Provider Name | Raymond Garcia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245217959 PECOS PAC ID: 5799973921 Enrollment ID: I20110103000546 |
| Provider Name | Lynn Wheeler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295039873 PECOS PAC ID: 5597948109 Enrollment ID: I20110318000832 |
| Provider Name | Eric R Onsgard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043566094 PECOS PAC ID: 6103069067 Enrollment ID: I20130826000715 |
| Provider Name | Carol L Craig |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083836928 PECOS PAC ID: 0547482952 Enrollment ID: I20141119000215 |
| Provider Name | Thomas E Wright |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639182868 PECOS PAC ID: 6406857507 Enrollment ID: I20150723006767 |
| Provider Name | Jennifer Fricke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487927885 PECOS PAC ID: 9032428719 Enrollment ID: I20151020001576 |
| Provider Name | Sherry T Aleksich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114173523 PECOS PAC ID: 3870652225 Enrollment ID: I20151223000181 |
| Provider Name | Kimberleigh Hagar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205254760 PECOS PAC ID: 7911202882 Enrollment ID: I20160302000213 |
| Provider Name | Christine L Grundeman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235438417 PECOS PAC ID: 6002112380 Enrollment ID: I20160314000003 |
| Provider Name | Melissa M Bachelder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659743946 PECOS PAC ID: 2062700701 Enrollment ID: I20161012000355 |
| Provider Name | Amy Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689927766 PECOS PAC ID: 8820387913 Enrollment ID: I20161102002757 |
| Provider Name | Julie A Worley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285613059 PECOS PAC ID: 5395787261 Enrollment ID: I20170124000524 |
| Provider Name | Livia L Klein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215290101 PECOS PAC ID: 0042462277 Enrollment ID: I20170208002751 |
| Provider Name | Lisa Chico |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417366394 PECOS PAC ID: 1254698798 Enrollment ID: I20171208000048 |
| Provider Name | Kristen Lynn Brokaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851806335 PECOS PAC ID: 4284993791 Enrollment ID: I20180108003103 |
| Provider Name | Carol Bradford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275041758 PECOS PAC ID: 1759644396 Enrollment ID: I20180413000920 |
| Provider Name | Alecia Lanette Greenlee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487072922 PECOS PAC ID: 4688977325 Enrollment ID: I20190708001233 |
| Provider Name | Ayesha K Ashai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174866800 PECOS PAC ID: 4082912209 Enrollment ID: I20190722001232 |
| Provider Name | Candice J Holder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376976530 PECOS PAC ID: 9032353206 Enrollment ID: I20190730000172 |
| Provider Name | Solomon G Zaraa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619170990 PECOS PAC ID: 3173715000 Enrollment ID: I20191028002315 |
| Provider Name | Laura L Meade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417502253 PECOS PAC ID: 5991037574 Enrollment ID: I20191031001176 |
| Provider Name | Salman Kazim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154437457 PECOS PAC ID: 1153410360 Enrollment ID: I20200123001417 |
| Provider Name | Sophie Mbua |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811534902 PECOS PAC ID: 4688002314 Enrollment ID: I20200311002817 |
| Provider Name | Debra Corrigan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043582273 PECOS PAC ID: 3577987502 Enrollment ID: I20200722003484 |
| Provider Name | Viengkeo Chanthaloth- Phasouk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366920811 PECOS PAC ID: 1153748447 Enrollment ID: I20200901002564 |
| Provider Name | Shannon Marie Ferriter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417435652 PECOS PAC ID: 5496169666 Enrollment ID: I20210129000305 |
| Provider Name | Lindsey Stewart |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689036758 PECOS PAC ID: 0042599227 Enrollment ID: I20210722002921 |
| Provider Name | Ryan M Sheehan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235697954 PECOS PAC ID: 1456755776 Enrollment ID: I20210810000176 |
| Provider Name | Christopher Lombardi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578097846 PECOS PAC ID: 3072910942 Enrollment ID: I20210920000991 |
| Provider Name | Ian Powell |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1346212545 PECOS PAC ID: 3274528591 Enrollment ID: I20211005003208 |
| Provider Name | Cynthia Clark Cushman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518934884 PECOS PAC ID: 9931146743 Enrollment ID: I20211118000060 |
| Provider Name | Joshua Ackerman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548677974 PECOS PAC ID: 7719297407 Enrollment ID: I20221221000642 |
| Provider Name | Blaine Minton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700224250 PECOS PAC ID: 4385885854 Enrollment ID: I20221221002411 |
| Provider Name | Taylor Pasquale |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295336634 PECOS PAC ID: 0345613550 Enrollment ID: I20230308001213 |
| Provider Name | Dorothy Deette Burke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497883169 PECOS PAC ID: 4587757042 Enrollment ID: I20230327002200 |
| Provider Name | Puneet Lakhmani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760046049 PECOS PAC ID: 1557694338 Enrollment ID: I20230405001810 |
| Provider Name | Mackenzie Christine Collins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821713322 PECOS PAC ID: 9638544570 Enrollment ID: I20230407000466 |
| Provider Name | Munjerina Ahmd Munmun |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295149920 PECOS PAC ID: 7315300530 Enrollment ID: I20230905003435 |
| Provider Name | Christina A Schneider |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528660867 PECOS PAC ID: 3779939525 Enrollment ID: I20231031000117 |
| Provider Name | Melissa Lee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124504428 PECOS PAC ID: 2163872359 Enrollment ID: I20240101000092 |
| Provider Name | Lori A Stanton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396874319 PECOS PAC ID: 2163872375 Enrollment ID: I20240102000077 |
| Provider Name | Cindy B Fisher |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1558608687 PECOS PAC ID: 5395196299 Enrollment ID: I20240104002833 |
| Provider Name | Carli Boyer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699225854 PECOS PAC ID: 2466803317 Enrollment ID: I20240104004549 |
| Provider Name | Amber Vowles |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477825990 PECOS PAC ID: 0941652705 Enrollment ID: I20240117001444 |
| Provider Name | Holly Brun |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013493410 PECOS PAC ID: 2163874934 Enrollment ID: I20240117001706 |
| Provider Name | Alexandra Kane |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124418314 PECOS PAC ID: 8224480074 Enrollment ID: I20240117004335 |
| Provider Name | Heather Fisher |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285156406 PECOS PAC ID: 1557713799 Enrollment ID: I20240123003828 |
| Provider Name | Kim Shird |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205873460 PECOS PAC ID: 1355784943 Enrollment ID: I20240212000516 |
| Provider Name | Kristie L Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689209736 PECOS PAC ID: 2769825363 Enrollment ID: I20240212000728 |
| Provider Name | Kathy Lynn Finley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417011412 PECOS PAC ID: 9234573551 Enrollment ID: I20240214003650 |
| Provider Name | Patrick Miranda |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831790617 PECOS PAC ID: 0446694798 Enrollment ID: I20240215000262 |
| Provider Name | David M. Kellerhals |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780984237 PECOS PAC ID: 0749625804 Enrollment ID: I20240228002099 |
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