NPI 1043507866

Luke Richard Frederick, MD

Practitioner Urology Physician Rockford, IL

Practice location

Address: 351 Executive Pkwy, Rockford, IL 61107-5339
Phone: (815) 398-4057
Fax: (815) 398-0220

Registered specialties (2)

Urology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208800000X Licence 036140866 (IL)

Other Urology providers in Illinois →

Urology Physician

Allopathic & Osteopathic Physicians Taxonomy 208800000X Licence 125.059642 (IL)

Registry record

NPI: 1043507866
Entity type: Individual
Sex (as registered): Male
NPI issued: 30 Jun 2011
Record last updated: 21 Jun 2016

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.