Organization
INTEGRATIVE MEDICAL OF ROCKFORD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JARED G ERDMIER DC (OWNER)
(779) 423-2044
Entity
Organization
Contact information
Practice address
863 S PERRYVILLE RD STE 100, ROCKFORD, IL 61108-4328
(779) 423-2044
(779) 423-2045
Mailing address
863 S. PERRYVILLE RD, ROCKFORD, IL 61108
(779) 423-2044
(779) 423-2045
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
05/31/2018
Last updated
03/31/2020
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