Individual
DR. LUKE RICHARD FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
351 EXECUTIVE PKWY, ROCKFORD, IL 61107-5339
(815) 398-4057
(815) 398-0220
Mailing address
351 EXECUTIVE PKWY, ROCKFORD, IL 61107-5339
(815) 398-4057
(815) 398-0220
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036140866
IL
208800000X
Urology Physician
125.059642
IL
Other
Enumeration date
06/30/2011
Last updated
06/21/2016
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