| NPI | 1538149364 |
|---|---|
| Former Legal Business Name | EAR, NOSE, & THROAT ASSOCIATES OF ROCKFORD |
| Entity Type | Organization |
| Authorized Contact | KIMBERLY MACMURCHY Contracting And Credentialing 815-398-3277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: IL 042007136) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2020-08-22 |