Individual
ILCHE TEODORE NONEVSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 ROXBURY RD, ROCKFORD, IL 61107-5075
(815) 397-7340
(815) 397-7388
Mailing address
401 ROXBURY RD, ROCKFORD, IL 61107-5075
(815) 397-7340
(815) 397-7388
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
36120349
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R01948
PTAN
IL
Enumeration date
03/05/2008
Last updated
01/30/2012
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