Individual
DR. JASON J KLOVNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1340 CHARLES ST STE 100, ROCKFORD, IL 61104-2200
(779) 696-8700
(779) 696-8745
Mailing address
PO BOX 78866, MILWAUKEE, WI 53278-8866
(779) 696-7150
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
026609
LA
208600000X
Surgery Physician
Primary
036-141917
IL
208600000X
Surgery Physician
55772
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100017464
—
WI
01
—
61243
DEAN HEALTH PLAN
WI
Enumeration date
03/10/2008
Last updated
03/01/2021
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