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526 W State St Rockford IL 61101-1214 | |
(779) 696-2770 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 526 W State St, Rockford, Illinois |
Authorized Official Name and Position | Don Daniels (VP, COO) |
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: (779) 696-7150 | 526 W State St Rockford IL 61101-1214 Ph: (779) 696-2770 |
NPI Number | 1992362685 |
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Provider Enumeration Date | 05/29/2019 |
Last Update Date | 06/04/2019 |
Identifier | Type | State | Issuer |
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1992362685 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family 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 | |