Ear Nose & Throat Specialists of Rockford SC
Ear Nose & Throat Specialists of Rockford SC is a Preferred Provider Organization in Rockford, Illinois. Licensed in Illinois. Registered with an NPI since 2007.
- Licensed in
- IL
- In the registry since
- 2007
Practice location Address checks out
435 N Mulford Rd Ste 10Rockford, IL 61107-5189
Phone: (815) 399-5268
Fax: (815) 399-3623
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Specialties & licences
| Preferred Provider Organization (primary) | Taxonomy 305R00000X · Licence 036067207 (IL) |
|---|
Record details
| NPI number | 1740491745 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | James Severson — Medical Doctor · (815) 399-5268 |
| Other names | James Melvin Severson |
| NPI enumerated | May 24, 2007 |
| Last updated in NPPES | March 27, 2012 |
| Mailing address | 435 N Mulford Rd, Suite 10, Rockford, IL 61107-5189 |
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