| Mathers Clinic, Llc | |
|
5804 Elaine Dr Rockford IL 61108-2435 | |
| (815) 397-7654 | |
| (815) 397-2712 |
| Full Name | Mathers Clinic, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 5804 Elaine Dr, Rockford, Illinois |
| Authorized Official Name and Position | Ramesh Babu Vemuri (VICE PRESIDENT) |
| Authorized Official Contact | 8153977654 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mathers Clinic, Llc 8420 W Bryn Mawr Ave Suite 620 Chicago IL 60631-3479 Ph: (773) 775-2800 | Mathers Clinic, Llc 5804 Elaine Dr Rockford IL 61108-2435 Ph: (815) 397-7654 |
| NPI Number | 1215194519 |
|---|---|
| Provider Enumeration Date | 05/22/2008 |
| Last Update Date | 05/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215194519 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | 36039266 (Illinois) | Primary |
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