Individual
IRENE DYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1560 RED OAK LN, ROCKFORD, IL 61107-2767
(815) 540-3722
Mailing address
1560 RED OAK LN, ROCKFORD, IL 61107-2767
(815) 540-3722
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.002716
IL
Other
Enumeration date
07/29/2015
Last updated
07/29/2015
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