Rockford Psychiatric Medical Services Sc

NPI 1144619750 - Nurse Practitioner - 363LP0808X

NPI Details
NPI 1144619750
Enumeration Date 01/20/2015
Last Updated 01/20/2015
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name WILLIAM WILLIAM
Position PRESIDENT
Phone (815) 395-1500
Fax (815) 395-1415
Practice Location
1639 N ALPINE RD
260
ROCKFORD IL, 61107-1449, US
Phone (815) 395-1500
Fax (815) 395-1415
Business Location
PO BOX 957
ROCKFORD IL, 61105-0957, US
Phone (815) 654-7772
Fax (815) 654-7009
Toxanomy
Taxonomy Code 363LP0808X
License State Illinois
License Number 209012268
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According to our database, Rockford Psychiatric Medical Services Sc NPI is 1144619750, taxonomy code is 363LP0808X and license number is 209012268, license state is located at Illinois. Rockford Psychiatric Medical Services Sc physically located at 1639 N Alpine Rd, Rockford IL, 61107-1449. NPI Number 1033115704 has the healthcare provider type.

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1144619750 NPI number is provided on an as is basis without warranty of any kind. 1144619750 is maintained by the National Plan & Provider Enumeration System. The contents of Rockford Psychiatric Medical Services Sc are for informational purposes only.