Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACK PETER KOTLARZ, MD
Active Sole ProprietorJACK PETER KOTLARZ, MD is a Plastic Surgery within the Head & Neck healthcare provider located in ROCKFORD, Illinois. NPI 1922090646 is currently active in the NPPES registry. Verify at CMS.
Plastic Surgery within the Head & Neck · ROCKFORD, IL
Registration Details
- NPI Number
- 1922090646
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 18, 2005 (21.013357356911 yrs)
- Last Updated
- Dec 10, 2024
- Licenses
-
ME62757 (FL)ME62757 (FL)2024013411 (MO)036170362 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1253 N ALPINE RDROCKFORD, IL, 611072201Browse IL providers · Browse ZIP 61107
- Phone
- 7796969201
- Fax
- 8153979667
- Primary Specialty
-
Plastic Surgery within the Head & Neck
207YX0007X
- Additional Specialty
- Otolaryngology
- Additional Specialty
- Otolaryngology
- Additional Specialty
- Plastic Surgery within the Head & Neck
Other Plastic Surgery within the Head & Neck Providers in ROCKFORD, IL
| Name | Credential | NPI |
|---|---|---|
| KENNETH RICHARD NISSIM | M.D. | 1447246392 |
| FAZLUR R. ZAHURULLAH | MD | 1720068695 |
| JONATHAN L. FERGUSON | MD | 1669452934 |
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.