Individual
DR. HEATHER ANNE HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2350 N ROCKTON AVE, ROCKFORD, IL 61103-3600
(815) 971-2248
(815) 971-9097
Mailing address
2350 N ROCKTON AVE, ROCKFORD, IL 61103-3600
(815) 971-2248
(815) 971-9097
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
036.123091
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036123091
STATE LICENSE
IL
Enumeration date
04/24/2007
Last updated
04/29/2021
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