Individual
DEANNA LYNN BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5666 E STATE ST, ROCKFORD, IL 61108-2425
(815) 226-2000
Mailing address
5666 E STATE ST, ROCKFORD, IL 61108-2425
(815) 226-2000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209018032
IL
Other
Enumeration date
06/17/2019
Last updated
06/17/2019
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