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Individual

DR. MICHAEL POTTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2780 MCFARLAND RD, PEDIATRICS, ROCKFORD, IL 61107-6807
(815) 971-3070
(815) 637-0040
Mailing address
2780 MCFARLAND RD, PEDIATRICS, ROCKFORD, IL 61107-6807
(815) 971-3070
(815) 637-0040

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036068700
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036068700
STATE LICENSE
IL
05
036068700
IL
Enumeration date
12/09/2005
Last updated
06/19/2015
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