Individual
DR. EDWARD ANDREW TELFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
444 ROXBURY ROAD, ROCKFORD, IL 61107-5059
(815) 398-3000
(815) 398-3041
Mailing address
PO BOX 6003, ROCKFORD, IL 61126-6003
(815) 398-3000
(815) 391-5096
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
36081182
IL
207RC0001X
Clinical Cardiac Electrophysiology Physician
36081182
IL
2085B0100X
Body Imaging Physician
36081182
IL
2085U0001X
Diagnostic Ultrasound Physician
36081182
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036081182 1
—
IL
01
—
101 15504
B/C B/S OF ILLINOIS
IL
01
—
CB0709/P00149580
RR MEDICARE GROUP#/PIN
GA
Enumeration date
07/18/2006
Last updated
11/12/2009
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