Individual
NANCY J. CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2400 N ROCKTON AVE, ROCKFORD, IL 61103-3655
(815) 971-5000
Mailing address
2400 N ROCKTON AVE, ROCKFORD, IL 61103-3655
(815) 971-5000
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
036-067902
IL
207VM0101X
Maternal & Fetal Medicine Physician
336.032045
IL
207VM0101X
Maternal & Fetal Medicine Physician
4301076946
MI
207VM0101X
Maternal & Fetal Medicine Physician
CS00222637
NM
207VM0101X
Maternal & Fetal Medicine Physician
MD2016-0001
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036067902
—
IL
Enumeration date
08/30/2006
Last updated
10/12/2020
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