Individual
DR. CHARLES SCOTT DEHAAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
124 N WATER ST, 208, ROCKFORD, IL 61107-3960
(815) 312-5810
(815) 312-5811
Mailing address
124 N WATER ST, 208, ROCKFORD, IL 61107-3960
(815) 312-5810
(815) 312-5811
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-064615
IL
Other
Enumeration date
11/14/2006
Last updated
12/02/2013
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