Organization · Type 2 NPI
Grand Victorian of Rockford, LLC
Point of Service · Rockford, IL
NPI number
1891991550
Active
Practice location
3495 Mcfarland Rd
Rockford, IL 61114-5609
Fax (815) 654-1488
Mailing address
78 Centennial Loop
Eugene, OR 97401-7900
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Point of Service Primary | 305S00000X | None listed |
Point of Service: This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost.
Another provider at this address
Other point of service providers in Rockford
About NPI 1891991550
Grand Victorian of Rockford, LLC's National Provider Identifier is 1891991550, issued on Jun 21, 2007. The primary taxonomy on file is Point of Service (305S00000X), and the practice location is in Rockford, IL. The record was last updated on May 13, 2008.