LOGAN KLOCKNER

ROCKFORD, IL
NPI1437743432
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: IL  209022924)
Additional Taxonomies163W00000X Registered Nurse
(Licence: IL  041366252)
Enumeration Date2021-02-22
Last Update Date2021-02-26
Business Address
LOGAN KLOCKNER
8201 E RIVERSIDE BLVD
ROCKFORD, IL 61114-2300
Phone number: 815-971-7000
Mailing Address
LOGAN KLOCKNER
2400 N ROCKTON AVE
ROCKFORD, IL 61103-3655
Phone number: 815-971-5000