Northern Illinois Vein Clinic, Llc

NPI 1407824022 - Radiology - 2085R0202X

NPI Details
NPI 1407824022
Enumeration Date 03/09/2006
Last Updated 12/05/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name EDWARD EDWARD
Position MD
Phone (815) 316-8346
Fax
Practice Location
1340 CHARLES ST
SUITE 404
ROCKFORD IL, 61104-2200, US
Phone (815) 316-8346
Fax
Business Location
PO BOX 4632
ROCKFORD IL, 61110-4632, US
Phone (815) 391-7285
Fax
Toxanomy
Taxonomy Code 2085R0202X
License State
License Number
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According to our database, Northern Illinois Vein Clinic, Llc NPI is 1407824022, taxonomy code is 2085R0202X Northern Illinois Vein Clinic, Llc physically located at 1340 Charles St, Rockford IL, 61104-2200. NPI Number 1033115704 has the healthcare provider type.

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1407824022 NPI number is provided on an as is basis without warranty of any kind. 1407824022 is maintained by the National Plan & Provider Enumeration System. The contents of Northern Illinois Vein Clinic, Llc are for informational purposes only.