institution
South Beloit Office
General Practice Physician in South Beloit, Illinois
NPI 1679839773

South Beloit Office is a General Practice Physician based in South Beloit, IL. South Beloit Office practices in South Beloit, IL. The NPI Number for South Beloit Office is 1679839773 and holds a License No. 036126253 (Illinois).

The current practice location address for South Beloit Office is 1407 Pate Plaza Dr, South Beloit, IL and can be reached out via phone at 630-219-2002.

Location: 1407 Pate Plaza Dr, South Beloit, IL, 61080-1431
institution
Provider Profile Details
NPI Number
1679839773
Provider Name
South Beloit Office
Credential
Provider Entity Type
Organization
Address
1407 Pate Plaza Dr, South Beloit, IL, 61080-1431
Phone Number
630-219-2002
Fax Number
Provider Enumeration Date
04/03/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
036-126253 05 IL
institution
Provider Business Practice Location Address Details
Address
1407 Pate Plaza Dr
City
State
Zip
61080-1431
Phone Number
630-219-2002
Fax Number
person
Provider Business Mailing Address Details
Address
1407 Pate Plaza Dr
City
State
Zip
61080-1431
Phone Number
630-219-2002
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
036126253 (Illinois)
Definition
Definition to come...
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