Individual
DR. CARL MICHAEL SIMONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
121 N MADISON ST, ROCKFORD, IL 61107-3949
(815) 963-3454
(815) 963-4384
Mailing address
121 N MADISON ST, ROCKFORD, IL 61107-3949
(815) 963-3454
(815) 963-4384
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08123272
BCBS
IL
Enumeration date
11/07/2006
Last updated
07/08/2007
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