Individual
MRS. REBECCA J NYGREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T., D.P.T.
Contact information
Practice address
3401 N PERRYVILLE RD, ROCKFORD, IL 61114-8011
(815) 971-2000
Mailing address
3401 N PERRYVILLE RD, ROCKFORD, IL 61114-8011
(815) 971-2000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070022562
IL
2251X0800X
Orthopedic Physical Therapist
Primary
070022562
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528513124
—
WI
Enumeration date
08/24/2016
Last updated
09/29/2020
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