Organization
RNA OF ROCKFORD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL J ROBERTSON M.D. (PRESIDENT)
(815) 227-8300
Entity
Organization
Contact information
Practice address
612 ROXBURY RD, ROCKFORD, IL 61107
(815) 227-8300
(815) 227-8301
Mailing address
612 ROXBURY RD, ROCKFORD, IL 61107-5089
(815) 227-8300
(815) 227-8301
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN1168
RAILROAD MEDICARE
IL
Enumeration date
01/22/2008
Last updated
04/18/2024
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