SAMUEL PARK

ROCKFORD, IL
NPI1720050495
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology
(Licence: IL  036063669)
Enumeration Date2006-02-06
Last Update Date2007-07-18
Business Address
-- SAMUEL PARK md
1400 CHARLES ST
ROCKFORD, IL 61104-2224
Phone number: 815-489-4267
Mailing Address
-- SAMUEL PARK md
PO BOX 15785
LOVES PARK, IL 61132-5785
Phone number: 815-654-7772
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