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Individual

DR. IRFAN MUNIRUDDIN ANKOLKAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-5000
Mailing address
2701 17TH STREET, ROCK ISLAND, IL 61201-0000
(309) 779-5000

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-119417
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036-119417
IL
01
95149
WELLMARK
IA
01
99854
WELLMARK
IA
01
P00616052
RR MEDICARE
IL
Enumeration date
03/21/2007
Last updated
10/02/2008
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