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Individual

KEVIN J PEIFER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
401 ROXBURY RD, ROCKFORD, IL 61107-5075
(815) 397-7340
(815) 397-2156
Mailing address
401 ROXBURY RD, ROCKFORD, IL 61107-5075
(815) 397-7340
(815) 397-2156

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
36114937
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2001008546
MO PHYSICIAN LICENSE
MO
01
36114937
IL PHYSICIAN LICENSE
IL
Enumeration date
12/22/2005
Last updated
09/06/2007
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