Individual
DR. KENNETH ERIC ANTONOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
6215 E STATE ST, ROCKFORD, IL 61108-2514
(414) 340-1844
Mailing address
6215 E STATE ST, ROCKFORD, IL 61108-2514
(414) 340-1844
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019026049
IL
122300000X
Dentist
Primary
050208
NY
122300000X
Dentist
Primary
6823-15
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
319014674
TAX ID
IL
Enumeration date
08/01/2006
Last updated
06/23/2026
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