Individual
DR. RONALD V. WASHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2300 N ROCKTON AVE, PLASTIC SURGERY DEPT, ROCKFORD, IL 61103-3619
(815) 971-2000
(815) 971-9924
Mailing address
2300 N ROCKTON AVE, PLASTIC SURGERY DEPT, ROCKFORD, IL 61103-3619
(815) 971-2000
(815) 971-9924
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
036-128815
IL
207YS0123X
Facial Plastic Surgery Physician
036-128815
IL
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
036128815
IL
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
036-128815
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265548945
—
WI
Enumeration date
08/22/2006
Last updated
01/29/2015
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