Ignacio Omengan
Pediatrics, Adolescent Medicine in Rockford, IL. Organization (NPI-2).
NPI number1689848541
StatusActive
Last updated in NPPESApr 22, 2008
Details
- NPI
- 1689848541
- Entity type
- Organization (NPI-2)
- Legal business name
- Ignacio Omengan
- Organization subpart
- No
- Enumeration date
- Apr 22, 2008
- Last updated
- Apr 22, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080A0000X | Pediatrics, Adolescent Medicine | 036101370 | IL | Yes |
Practice location
461 N Mulford RdSuite #10
Rockford, IL 61107-5190
Phone 815-394-1930 · Fax 815-395-1064
Mailing address
461 N Mulford RdSuite #10
Rockford, IL 61107-5190
Phone 815-394-1930 · Fax 815-395-1064
Authorized official
Ignacio Uy Omengan
Doctor/Owner
8153941930
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