Individual
JUDITH ANN GIOLITTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4423 MANCHESTER DR, ROCKFORD, IL 61109-1655
(815) 394-1391
(815) 226-0114
Mailing address
5510 E STATE ST, ROCKFORD, IL 61108-2381
(815) 395-4516
(815) 395-4600
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036051509
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036051509
—
IL
01
—
553180
MEDICARE GROUP NUMBER
IL
01
—
553180027
MEDICARE INDIVIDUAL ID
IL
01
—
834340
MEDICARE GROUP PTAN
IL
Enumeration date
06/21/2006
Last updated
01/20/2010
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