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1902127749
JENNIFER L FASANO
ROCKFORD, IL
NPI
1902127749
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Former Name
JENNIFER SIMMONS
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IL 209007750)
Enumeration Date
2010-06-16
Last Update Date
2010-06-16
Business Address
-- JENNIFER L FASANO APN
444 ROXBURY RD
ROCKFORD, IL 61107-5059
Phone number: 815-398-3000
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Mailing Address
-- JENNIFER L FASANO APN
444 ROXBURY RD
ROCKFORD, IL 61107-5059
Phone number:
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