Organization
ROCKFORD UROLOGICAL ASSOCIATES, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON PICK (COO)
(815) 398-4057
Entity
Organization
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
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036051080
—
IL
05
—
036054674
—
IL
05
—
036058803
—
IL
05
—
036066868
—
IL
05
—
036067790
—
IL
05
—
036080935
—
IL
05
—
036099544
—
IL
Enumeration date
03/28/2006
Last updated
12/22/2023
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