| Board Of Trustees Of The University Of Illinois | |
|
1511 N Blackhawk Blvd Rockton IL 61072-1513 | |
| (815) 264-2644 | |
| (815) 264-2186 |
| Full Name | Board Of Trustees Of The University Of Illinois |
|---|---|
| Speciality | Family Medicine |
| Location | 1511 N Blackhawk Blvd, Rockton, Illinois |
| Authorized Official Name and Position | John Fitzhorn (DIRECTOR OF PATIENT ACCOUNTS) |
| Authorized Official Contact | 8153955892 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Board Of Trustees Of The University Of Illinois 1601 Parkview Ave S300 Rockford IL 61107-1822 Ph: (815) 395-5892 | Board Of Trustees Of The University Of Illinois 1511 N Blackhawk Blvd Rockton IL 61072-1513 Ph: (815) 264-2644 |
| NPI Number | 1952348831 |
|---|---|
| Provider Enumeration Date | 06/01/2006 |
| Last Update Date | 09/10/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952348831 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |