NPI 1013077619

Psychiatric Associates of Rockford Sc

Organisation Psychiatry Physician Rockford, IL

Practice location

Address: 6078 Palo Verde Dr, Rockford, IL 61114-8117
Phone: (815) 398-9360
Fax: (815) 398-1028

Authorised official

Name: Peter Smith
Title: Credentialing Manager
Phone: (815) 965-8505

Registered specialties

Psychiatry Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2084P0800X

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Registry record

NPI: 1013077619
Entity type: Organization
NPI issued: 12 Dec 2006
Record last updated: 6 Dec 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.