Unknown Individual – Pediatric Cardiology Physician, NPI 1962457499
Pediatric Cardiology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
Cammalot Tower, 1415, East State Street, Rockford, Winnebago County, Illinois, 61104, United States
SUITE 601
ROCKFORD, IL 61104
Phone: (815) 966-1221
Fax: (815) 966-1225
Type: Location
6526, Spring Brook Road, Rockford, Rockford Township, Winnebago County, Illinois, 61114, United States
APT 212
ROCKFORD, IL 611148125
Phone: (407) 488-7667
Type: Mailing
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)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 61104)
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