Individual
DR. SCOTT R HOMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1340 CHARLES ST STE 404, ROCKFORD, IL 61104-2200
(779) 696-1890
(779) 696-5898
Mailing address
PO BOX 78866, MILWAUKEE, WI 53278-8866
(779) 696-7150
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036-069323
IL
207RI0200X
Infectious Disease Physician
Primary
036069323
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-069323
—
IL
Enumeration date
07/21/2005
Last updated
04/15/2021
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