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Individual

DR. ARPANA BROOR MATHUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
698 FEATHERSTONE RD, SUITE 250, ROCKFORD, IL 61107-6303
(815) 399-4404
(815) 484-7091
Mailing address
698 FEATHERSTONE RD, SUITE 250, ROCKFORD, IL 61107-6303
(815) 399-4404
(815) 484-7091

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036113594
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0-551-903-8
ECFMG NUMBER
IL
01
036113594
IL STATE LICENSE
IL
05
036113594
IL
01
336074258
IL STATE CTL SUBS LICENSE
IL
01
553180
MEDICARE GROUP PTAN
IL
01
834370
MEDICARE GROUP
IL
Enumeration date
11/18/2005
Last updated
03/07/2023
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