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Individual

MR. ROLANDO PEREZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
IMG, LSA

Contact information

Practice address
1491 STONY CREEK WAY, APT 2, ROCKFORD, IL 61108-1210
(832) 425-5634
Mailing address
PO BOX 7546, ROCKFORD, IL 61126-7546
(832) 425-5634

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
SA00087
TX
363AS0400X
Surgical Physician Assistant
Primary
SA00087
TX

Other

Enumeration date
09/26/2006
Last updated
11/14/2012
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