Individual
CHARLES WELFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5707 STRATHMOOR DR, ROCKFORD, IL 61107-5161
(815) 398-9386
Mailing address
5707 STRATHMOOR DR, ROCKFORD, IL 61107-5161
(815) 398-9386
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
3657923
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036057923
—
IL
Enumeration date
11/23/2005
Last updated
08/19/2011
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