Individual
DR. JOHN J. BOTTROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5875 E RIVERSIDE BLVD, ROCKFORD, IL 61114-4937
(815) 398-9491
(815) 381-7498
Mailing address
PO BOX 735263, CHICAGO, IL 60673-5263
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036128556
IL
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
036128556
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036128556
—
IL
Enumeration date
12/12/2007
Last updated
08/03/2023
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