Individual
DR. ANN AGUSTSSON MATHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1601 PARKVIEW AVE, ROCKFORD, IL 61107-1822
(815) 395-5870
(815) 395-5750
Mailing address
1601 PARKVIEW AVE, ROCKFORD, IL 61107-1822
(815) 395-5870
(815) 395-5750
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036039266
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036039266
STATE MEDICAL LICENSE
IL
Enumeration date
04/20/2006
Last updated
03/07/2023
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