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

Organization Surgical Critical Care Physician · NPI 1073679411

Rockford Surgical Service, SC is a Surgical Critical Care Physician in Rockford, Illinois. Licensed in Illinois. Registered with an NPI since 2006.

Licensed in
IL
In the registry since
2006
Specialties on file
5
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Practice location Address checks out

5668 E State St SUITE1000
Rockford, IL 61108-2490
Phone: (815) 397-7900
Fax: (815) 397-7919
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician (primary) Taxonomy 208G00000X (IL)
Surgical Critical Care Physician Taxonomy 2086S0102X · Licence 04200060 (IL)
Surgery Physician Taxonomy 208600000X (IL)
Vascular Surgery Physician Taxonomy 2086S0129X (IL)
Colon & Rectal Surgery Physician Taxonomy 208C00000X (IL)

Record details

NPI number1073679411
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Leslie Edgcomb — President · (815) 397-7900
NPI enumeratedDecember 29, 2006
Last updated in NPPESSeptember 11, 2025
Mailing address5668 E State St, Suite1000, Rockford, IL 61108-2490

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