Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 036-090937 | IL |
NPI | 1033229224 |
---|---|
Provider Name | Robin R. Hovis |
First Address | Rockford, IL 61103-3619 |
Second Address | Rockford, IL 61103-3619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 03/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E92189 | (02) | IL |