| Midwest Medical Institute S.c. | |
|
5251 Crestdale Dr Rockford IL 61114-6413 | |
| (815) 209-7050 | |
| Not Available |
| Full Name | Midwest Medical Institute S.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 5251 Crestdale Dr, Rockford, Illinois |
| Authorized Official Name and Position | Vasil Nika (OWNER) |
| Authorized Official Contact | 8152097050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Medical Institute S.c. 5251 Crestdale Dr Rockford IL 61114-6413 Ph: () - | Midwest Medical Institute S.c. 5251 Crestdale Dr Rockford IL 61114-6413 Ph: (815) 209-7050 |
| NPI Number | 1811792419 |
|---|---|
| Provider Enumeration Date | 02/17/2025 |
| Last Update Date | 02/17/2025 |
| Medicare PECOS PAC ID | 1557882552 |
|---|---|
| Medicare Enrollment ID | O20250306002072 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811792419 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Vasil Nika |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811987886 PECOS PAC ID: 0648331330 Enrollment ID: I20081213000173 |
| Provider Name | Megan M Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760730576 PECOS PAC ID: 3779736673 Enrollment ID: I20121228000338 |
| Provider Name | Jody Gosnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235687989 PECOS PAC ID: 6709173214 Enrollment ID: I20160928000145 |
| Provider Name | Rachele Becker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831976943 PECOS PAC ID: 1850740960 Enrollment ID: I20231214003303 |
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