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1401 E State St Rockford IL 61104-2315 | |
(815) 489-4760 | |
Not Available |
Full Name | |
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Speciality | Internal Medicine |
Location | 1401 E State St, Rockford, Illinois |
Authorized Official Name and Position | Don Daniels (VP) |
Authorized Official Contact | 8159662084 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 4073 Rockford IL 61110-0573 Ph: () - | 1401 E State St Rockford IL 61104-2315 Ph: (815) 489-4760 |
NPI Number | 1679723142 |
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Provider Enumeration Date | 09/22/2008 |
Last Update Date | 09/22/2008 |
Identifier | Type | State | Issuer |
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1679723142 | NPI | - | NPPES |
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 | |