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2829 Glenwood Ave Rockford IL 61101-3542 | |
(815) 962-0633 | |
(815) 962-0142 |
Full Name | |
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Speciality | Internal Medicine |
Location | 2829 Glenwood Ave, Rockford, Illinois |
Authorized Official Name and Position | Shirley E Kittle-kraus (OFFICE MANAGER) |
Authorized Official Contact | 8159620633 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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2829 Glenwood Ave Rockford IL 61101-3542 Ph: (815) 962-0633 | 2829 Glenwood Ave Rockford IL 61101-3542 Ph: (815) 962-0633 |
NPI Number | 1831391424 |
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Provider Enumeration Date | 06/05/2007 |
Last Update Date | 12/31/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1831391424 | NPI | - | NPPES |
1831391424 | Other | IL | GROUP |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Gautam Gupta Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6090 Strathmoor Dr, Suite #4, Rockford, IL 61107 Phone: 815-229-1899 Fax: 815-231-1218 | |
Rockford School District Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 N Gardiner Ave, Rockford, IL 61107 Phone: 815-398-3976 | |
Rockford Adult Medicine Associates S C Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 534 Roxbury Rd, Rockford, IL 61107 Phone: 815-381-7005 | |