Individual
MARIA LOZANO VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 W STATE ST, ROCKFORD, IL 61102-2112
(815) 490-1600
Mailing address
1200 W STATE ST, ROCKFORD, IL 61102-2112
(815) 490-1600
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036135118
IL
390200000X
Student in an Organized Health Care Education/Training Program
125060321
IL
Other
Enumeration date
06/24/2011
Last updated
06/19/2014
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