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1340 Charles St Suite 400 Rockford IL 61104 | |
(779) 696-9512 | |
Not Available |
Full Name | |
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Speciality | Neurological Surgery |
Location | 1340 Charles 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 78866 Milwaukee WI 53278-8866 Ph: () - | 1340 Charles St Suite 400 Rockford IL 61104 Ph: (779) 696-9512 |
NPI Number | 1366672958 |
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Provider Enumeration Date | 07/17/2009 |
Last Update Date | 07/12/2018 |
Identifier | Type | State | Issuer |
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1366672958 | NPI | - | NPPES |
062 | Other | IL | TRICARE |
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