Organization
ROCKFORD REHABILITATION MEDICINE, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER PARK MD (MD)
(815) 965-9712
Entity
Organization
Contact information
Practice address
2825 GLENWOOD AVE, ROCKFORD, IL 61101-3542
(815) 965-9712
Mailing address
2825 GLENWOOD AVE, ROCKFORD, IL 61101-3542
(815) 965-9712
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
04/27/2006
Last updated
08/22/2020
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