Provider Demographics
NPI:1265486849
Name:FEATHERSTONE PARTNERSHIP LP
Entity Type:Organization
Organization Name:FEATHERSTONE PARTNERSHIP LP
Other - Org Name:ROCKFORD AMBULATORY SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GUNDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:815-231-5450
Mailing Address - Street 1:PO BOX 4661
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61110-4661
Mailing Address - Country:US
Mailing Address - Phone:815-226-3300
Mailing Address - Fax:815-226-9990
Practice Address - Street 1:1016 FEATHERSTONE RD
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-5902
Practice Address - Country:US
Practice Address - Phone:815-226-3300
Practice Address - Fax:815-226-9990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL7001928261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL490002678OtherRAILROAD MEDICARE PRO #
IL490002678OtherRAILROAD MEDICARE PRO #