| David Cook, | |
|
1221 E State St, Rockford, IL 61104-2231 | |
| (815) 972-1037 | |
| Not Available |
| Full Name | David Cook |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 1221 E State St, Rockford, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043955768 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 125.080373 (Illinois) | Primary |
| Entity Name | Ksb Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073592119 PECOS PAC ID: 7911890009 Enrollment ID: O20040203000860 |
| Entity Name | Katherine Shaw Bethea Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427043546 PECOS PAC ID: 2264480037 Enrollment ID: O20081218000029 |
| Mailing Address | Practice Location Address |
|---|---|
| David Cook, 1501 E Gardner Ln Apt 614, Peoria Heights, IL 61616-3625 Ph: () - | David Cook, 1221 E State St, Rockford, IL 61104-2231 Ph: (815) 972-1037 |
Srivani Sridhar, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3505 N. Bell School Rd., Rockford, IL 61114 Phone: 779-696-0300 | |
Dr. John Wall, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1200 W State St, Rockford, IL 61102 Phone: 815-490-1600 | |
Dr. Steven J Lidvall, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1215 N Alpine Rd, Rockford, IL 61107 Phone: 815-391-7807 | |
Dr. Arpana Broor Mathur, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 698 Featherstone Rd, Suite 250, Rockford, IL 61107 Phone: 815-399-4404 Fax: 815-484-7091 | |
Ms. Rachael Mcpeek, NP Family Medicine Medicare: Medicare Enrolled Practice Location: 1215 N Alpine Rd, Rockford, IL 61107 Phone: 815-490-1600 | |
Dr. Jithinraj Edakkanambeth Varayil, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1200 W State St, Rockford, IL 61102 Phone: 815-490-1600 Fax: 815-490-1881 | |
Dr. Raju M Shanmugam, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3401 N Perryville Rd, Rockford, IL 61114 Phone: 815-971-2000 Fax: 815-971-2000 |