Registry details
Type
Organization
Primary specialty
Surgery
Enumerated
May 24, 2005
License(s)
036104533 (IL), 036063647 (IL), 036064410 (IL), 036048085 (IL), 036101179 (IL), 036067268 (IL), 036064323 (IL), 085002211 (IL), 209004303 (IL), 036071666 (IL), 036062833 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | PO BOX 15730 | Loves Park, IL 61132-5730 | 815-964-3333 |
| LOCATION | 2300 N ROCKTON AVE STE 304 | Rockford, IL 61103-3619 | 815-964-3333 |
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