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Individual

KRYSTLE N LANGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
1340 CHARLES ST STE 100, ROCKFORD, IL 61104-2200
(779) 696-8700
(779) 696-8745
Mailing address
PO BOX 1567, ROCKFORD, IL 61110-0067
(779) 696-7150

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036143818
IL
208600000X
Surgery Physician
R-9506
IA

Other

Enumeration date
06/21/2012
Last updated
07/21/2022
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