Organization
PSYCHIATRIC ASSOCIATES OF ROCKFORD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER SMITH (CREDENTIALING MANAGER)
(815) 965-8505
Entity
Organization
Contact information
Practice address
6078 PALO VERDE DR, ROCKFORD, IL 61114-8117
(815) 398-9360
(815) 398-1028
Mailing address
6078 PALO VERDE DR, ROCKFORD, IL 61114-8117
(815) 398-9360
(815) 398-1028
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
12/12/2006
Last updated
12/06/2011
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