Individual
AMANDA MACKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1200 WEST STATE STREET, ROCKFORD, IL 61102-2112
(815) 490-1600
(815) 490-1881
Mailing address
1200 WEST STATE STREET, ROCKFORD, IL 61102-2112
(815) 490-1600
(815) 490-1881
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209013183
IL
Other
Enumeration date
08/02/2016
Last updated
01/16/2020
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