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1730777145
MARLA JO VANVICKLE
ROCKFORD, IL
NPI
1730777145
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IL 209021926)
Enumeration Date
2021-01-02
Last Update Date
2022-04-13
Business Address
Mrs. MARLA JO VANVICKLE APN
4215 NEWBURG RD
ROCKFORD, IL 61108-6479
Phone number: 815-988-8500
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Mailing Address
Mrs. MARLA JO VANVICKLE APN
4215 NEWBURG RD
ROCKFORD, IL 61108-6479
Phone number: 815-988-8500
Copy
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