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Organization

WARREN L LOWRY SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WARREN L LOWRY MD (PRESIDENT)
(815) 397-6642
Entity
Organization

Contact information

Practice address
1340 CHARLES ST, SUITE 200, ROCKFORD, IL 61104-2200
(815) 397-6642
(815) 397-6659
Mailing address
1340 CHARLES ST, SUITE 200, ROCKFORD, IL 61104-2200
(815) 397-6642
(815) 397-6659

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036038948
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036038948
IL
01
10120361
BLUE CROSS BLUE SHIELD
IL
01
791342073
RAILROAD MEDICARE PALMETT
IL
Enumeration date
07/15/2006
Last updated
12/17/2012
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