Individual
JEROME S WEISKOPF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6533 LEXUS DRIVE, ROCKFORD, IL 61108-3015
(815) 397-4180
(815) 397-1250
Mailing address
6533 LEXUS DRIVE, ROCKFORD, IL 61108-3015
(815) 397-4180
(815) 397-1250
Taxonomy
Speciality
Code
Description
License number
State
2086S0105X
Surgery of the Hand (Surgery) Physician
Primary
03652893
IL
2086S0122X
Plastic and Reconstructive Surgery Physician
03652893
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036052893
—
IL
01
—
101-00485
BLUE CROSS IF IL
IL
01
—
131087000
US DEPT OF LABOR
—
01
—
31303800
WI PUBLIC AID
WI
01
—
362958896015
BLUE CROSS OF WI
WI
01
—
791240158
RAILROAD MEDICARE
—
Enumeration date
08/29/2006
Last updated
07/25/2008
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