Susan M Fowell in Rockford - Retina Specialist
Susan M Fowell - NPI 1821091075
Susan M Fowell is a Retina Specialist in Rockford, Illinois. Susan M Fowell practices all healthcare services and medical treatments related to Retina Specialist. The NPI Number for Susan M Fowell is 1821091075. The last update date is 2017-07-06.
Susan M Fowell's current location address is 1235 N Mulford Rd, Rockford, Illinois. You can contact this provider via phone number 8152264990 and fax number 8152269472. The mailing address for Susan M Fowell is 1235 N Mulford Rd, Rockford, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Susan M Fowell |
|---|---|
| Address | 1235 N Mulford Rd, Rockford, Illinois |
| Phone Number | 8152264990 |
| Fax Number | 8152269472 |
| Sole Proprietor | Y |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1821091075 |
|---|---|
| Provider Enumeration Date | 2005-05-23 |
| Last Updated Date | 2017-07-06 |
Provider Mailing Address Detail
| Address | 1235 N Mulford Rd |
|---|---|
| City | Rockford |
| State | Illinois (IL) |
| Post Code | 6110738790 |
| Phone Number | 8152264990 |
| Fax Number | 8152269472 |
Provider's Primary Taxonomy Detail
| Speciality | Retina Specialist |
|---|---|
| Taxonomy | 207Wx0107X |
| Licence No | 36073359 |
|
Definition: An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 363734974 | IL | TAX ID# | |
| 36073359 | IL | -- | |
| 36073359 | IL | IL STATE LICENSE # |
Post Comment/ Review Below
What is the unique provider identifier assigned to Susan M Fowell?
The Susan M Fowell has been issued the NPI (National Provider Identifier) 1821091075 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please share the complete physical address where Susan M Fowell is geographically located?
The Susan M Fowell is physically situated at the following location: 1235 N Mulford Rd, Rockford, IL, 6110738790.
When did Susan M Fowell receive its 1821091075 assignment?
The Susan M Fowell was assigned its 1821091075 on 2005-05-23, which is the date when this unique identifier was issued to the organization.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1821091075 to Susan M Fowell?
The Centers for Medicare & Medicaid Services originally issued the 1821091075 to Susan M Fowell on 2005-05-23.
As of what date were the details pertaining to Susan M Fowell last refreshed?
The information related to the Susan M Fowell, including its address, specialty, and other relevant details, was last updated on 2017-07-06.
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