Individual
WALEED MANSOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
8201 E RIVERSIDE BLVD, ROCKFORD, IL 61114-2300
(815) 971-7000
Mailing address
8201 E RIVERSIDE BLVD, ROCKFORD, IL 61114-2300
(815) 971-7000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036143374
IL
207P00000X
Emergency Medicine Physician
74297
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036143374
—
IL
05
—
1043628589
—
WI
Enumeration date
07/29/2014
Last updated
04/27/2026
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