Individual provider · Type 1 NPI

Michaela Rose Blackwell, PA-C

Physician Assistant · Rockford, IL

NPI number 1407553019 Active

Practice location

5875 E Riverside Blvd
Rockford, IL 61114-4937

Call (815) 398-9491 Map

Mailing address

PO Box 735263
Chicago, IL 60673-5263

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X085010688 (IL)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1407553019

Michaela Rose Blackwell, PA-C's National Provider Identifier is 1407553019, issued on Feb 14, 2023. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Rockford, IL. The record was last updated on Nov 1, 2024.