Unknown Individual – Specialist, NPI 1730189689
Specialist
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
129, Phelps Avenue, Rockford, Winnebago County, Illinois, 61108, United States
SUITE 508
ROCKFORD, IL 611082453
Phone: (815) 229-2300
Fax: (815) 229-3909
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 61108)
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