Individual
MATTHEW KOTTACKAL GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5666 E STATE ST, ROCKFORD, IL 61108-2425
(815) 226-2000
Mailing address
6421 BURBERRY DR, ROCKFORD, IL 61114-7807
(518) 391-0548
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
036166381
IL
2086S0129X
Vascular Surgery Physician
Primary
036.166381
IL
Other
Enumeration date
04/08/2015
Last updated
02/06/2026
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