Individual
MRS. MARY FRANCES ZINGRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
1340 CHARLES ST, SUITE 400, ROCKFORD, IL 61104
(779) 696-9512
Mailing address
PO BOX 78866, MILWAUKEE, WI 53278-8866
(779) 696-7150
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-002640
IL
363AS0400X
Surgical Physician Assistant
085002640
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
436860002
MEDICARE PTAN #
IL
Enumeration date
04/28/2006
Last updated
02/18/2021
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