Individual
APEKSHA KUKADIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6055 E STATE ST, ROCKFORD, IL 61108-2512
(815) 394-7412
Mailing address
6055 E STATE ST, ROCKFORD, IL 61108-2512
(815) 394-7412
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046011736
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/09/2023
Last updated
07/21/2023
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