JACK PETER KOTLARZ

ROCKFORD, IL
NPI1922090646
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck
(Licence: IL  036170362)
Additional Taxonomies174400000X Specialist
(Licence: FL  ME62757)
207Y00000X Otolaryngology
(Licence: FL  ME62757)
207Y00000X Otolaryngology
(Licence: MO  2024013411)
Enumeration Date2005-08-18
Last Update Date2024-12-10
Business Address
JACK PETER KOTLARZ MD
1253 N ALPINE RD
ROCKFORD, IL 61107-2201
Phone number: 779-696-9201
Mailing Address
JACK PETER KOTLARZ MD
6100 NORTH DAVIS HWY
PENSACOLA, FL 32504-6950
Phone number: 850-471-2377