Board Of Trustees Of The University Of Illinois
Psychiatry & Neurology, Psychiatry in Rockford, IL. Organization (NPI-2).
NPI number1699713636
StatusActive
Last updated in NPPESSep 10, 2007
Details
- NPI
- 1699713636
- Entity type
- Organization (NPI-2)
- Legal business name
- Board Of Trustees Of The University Of Illinois
- Organization subpart
- No
- Enumeration date
- Jun 3, 2006
- Last updated
- Sep 10, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology, Psychiatry | – | – | Yes |
Other names
- University Psychiatric Clinic (Doing Business As)
Practice location
1601 Parkview AveRockford, IL 61107-1822
Phone 815-395-5870
Mailing address
1601 Parkview AveS300
Rockford, IL 61107-1822
Phone 815-395-5892 · Fax 815-395-5644
Authorized official
John Fitzhorn
Director Of Patient Accounts
8153955892
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