Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lakeside Anesthesiology, SC

Organization Non-Pharmacy Dispensing Site · NPI 1477897023

Lakeside Anesthesiology, SC is a Non-Pharmacy Dispensing Site in Rockford, Illinois. Registered with an NPI since 2012.

In the registry since
2012

Practice location Address checks out

761 Highgrove Pl
Rockford, IL 61108-2520
Phone: (815) 209-2525
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Non-Pharmacy Dispensing Site (primary) Taxonomy 332900000X

Record details

NPI number1477897023
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationLakeside Anesthesiology, SC
Authorized official David Footerman — President · (815) 209-2525
Other names 1body4life
NPI enumeratedNovember 20, 2012
Last updated in NPPESNovember 20, 2012
Mailing address2980 N Beverly Glen Cir, Suite 301, Los Angeles, CA 90077-1726

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