Organization
JACK W. LENOX, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK W LENOX (PRESIDENT)
(815) 965-6644
Entity
Organization
Contact information
Practice address
1415 E STATE ST STE 800, ROCKFORD, IL 61104-2344
(815) 965-6644
(815) 965-8974
Mailing address
1415 E STATE ST STE 800, ROCKFORD, IL 61104-2344
(815) 965-6644
(815) 965-8974
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
036068164
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036068164
—
IL
Enumeration date
05/05/2008
Last updated
05/06/2008
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