BASSAM SOUFAN

ROCKFORD, IL
NPI1356451546
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: IL  036-077791)
Enumeration Date2006-08-30
Last Update Date2010-01-18
Business Address
BASSAM SOUFAN MD
2350 N ROCKTON AVE
ROCKFORD, IL 61103-3600
Phone number: 815-971-2000
Mailing Address
BASSAM SOUFAN MD
2350 N ROCKTON AVE
ROCKFORD, IL 61103-3600
Phone number: 815-971-2000