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Individual

DR. EDWIN OKESON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1200 W STATE ST, ROCKFORD, IL 61102-2112
(815) 490-1600
Mailing address
1816 HAWTHORNE DR, ROCKFORD, IL 61107-1340
(815) 395-0383

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036067805
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036067805
IL
Enumeration date
11/30/2005
Last updated
05/05/2010
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