Individual
GREG MYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P
Contact information
Practice address
1401 E STATE ST, ROCKFORD, IL 61104-2298
(779) 696-0400
Mailing address
3684 VALERIE RD, ROSCOE, IL 61073-8916
(815) 540-6323
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209023686
IL
Other
Enumeration date
08/23/2021
Last updated
09/26/2022
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