KRYSTLE N LANGE

ROCKFORD, IL
NPI1770846974
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy208600000X Surgery
(Licence: IL  036143818)
Additional Taxonomies208600000X Surgery
(Licence: IA  R-9506)
Enumeration Date2012-06-21
Last Update Date2022-07-21
Business Address
-- KRYSTLE N LANGE D.O.
1340 CHARLES ST STE 100
ROCKFORD, IL 61104-2200
Phone number: 779-696-8700
Mailing Address
-- KRYSTLE N LANGE D.O.
PO BOX 1567
ROCKFORD, IL 61110-0067
Phone number: 779-696-7150