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Individual

GORDON EGGERS

Active
Sole proprietor

Provider details

NPI number
Gender
Man

Contact information

Practice address
1200 W STATE ST, ROCKFORD, IL 61102-2112
(815) 490-1600
Mailing address
10729 WHISPERING PINES WAY, ROCKFORD, IL 61114-6843
(815) 885-1334

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0085000278
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0085000278
IL
Enumeration date
11/23/2005
Last updated
07/09/2007
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