Individual
JONATHAN L. FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
698 FEATHERSTONE RD, ROCKFORD, IL 61107-6303
(815) 398-3277
(815) 484-7001
Mailing address
698 FEATHERSTONE RD, ROCKFORD, IL 61107-6303
(815) 398-3277
(815) 484-7001
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
036078516
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036078516
—
IL
Enumeration date
01/20/2006
Last updated
09/21/2011
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