Individual
TAREK JAZAERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1401 E STATE ST, ROCKFORD, IL 61104-2315
(779) 696-4273
Mailing address
1401 E STATE ST, ROCKFORD, IL 61104-2315
(779) 696-4273
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036.145525
IL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
4301091867
MI
Other
Enumeration date
05/12/2010
Last updated
08/01/2019
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