# IRENE BOSWELL MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912216284
- **Authorized official:** DR. IRENE MARY BOSWELL MD (PHYSICIAN)
- **Authorized official phone:** (815) 332-1777

## Contact information

- **Practice address:** 7445 NEWBURG RD, SUITE 103, ROCKFORD, IL 61108-4443
- **Practice address phone:** (815) 332-1777
- **Practice address fax:** (815) 332-1655
- **Mailing address:** 7445 NEWBURG RD, SUITE 103, ROCKFORD, IL 61108-4443
- **Mailing address phone:** (815) 332-1777
- **Mailing address fax:** (815) 332-1655

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 036091532 | IL | Yes |

## Other

- **Enumeration date:** 10/04/2010
- **Last updated:** 10/04/2010