Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. SUSAN M FOWELL, MD
Active Sole ProprietorDR. SUSAN M FOWELL, MD is a Sports Medicine (Emergency) healthcare provider located in ROCKFORD, Illinois. NPI 1821091075 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine (Emergency) · ROCKFORD, IL
Registration Details
- NPI Number
- 1821091075
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- May 23, 2005 (21.26594450678 yrs)
- Last Updated
- Jul 6, 2017
- Licenses
-
036073359 (IL)036073359 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1235 N MULFORD RDSUITE 100ROCKFORD, IL, 611073879Browse IL providers · Browse ZIP 61107
- Phone
- 8152264990
- Fax
- 8152269472
- Primary Specialty
-
Sports Medicine (Emergency)
207WX0107X
- Additional Specialty
- Sports Medicine (Emergency)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.