Individual
DR. DONALD E MCCANSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2300 N ROCKTON AVE, STE 304, ROCKFORD, IL 61103-3619
(815) 964-3333
(815) 964-3331
Mailing address
PO BOX 15730, LOVES PARK, IL 61132-5730
(815) 964-3333
(815) 964-3331
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
IL
2086S0127X
Trauma Surgery Physician
—
IL
208C00000X
Colon & Rectal Surgery Physician
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036064410 2
—
IL
01
—
194360
PERSONAL CARE
IL
Enumeration date
06/23/2005
Last updated
12/17/2007
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