Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | IL |
NPI | 1134138639 |
---|---|
Provider Name | Dr. Andrew C Hills |
First Address | Rockford, IL 61107-4877 |
Second Address | Rockford, IL 61107-4877 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
L55404 | (02) | IL |