Organization
SWEDISHAMERICAN HOSPITAL
Active
Organization
SWEDISHAMERICAN HOSPITAL
Active
Other names
Centegra Physician Care Woodstock
Organization subpart
No
Provider details
NPI number
Authorized official
DON DANIELS (VP)
(815) 966-2084
Entity
Organization
Contact information
Practice address
3707 DOTY RD, MEDICAL OFFICE BUILDING 2, WOODSTOCK, IL 60098-7530
(815) 388-2500
Mailing address
PO BOX 1567, ROCKFORD, IL 61110-0067
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
—
—
Other
Enumeration date
03/20/2007
Last updated
12/09/2011
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