Bullis, Gregory

Bullis, Gregory is an individual health care provider with primary practice located at 5666 East State St , Rockford IL 61108-2472. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medical Services, which is considered as his primary health care specialty. Bullis, Gregory can be contacted via phone (815) 226-2000.

Contact Information

Primary practice address
5666 East State St Rockford IL 61108-2472
Fax: (815) 381-7582
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 036067306 Illinois

Profile Details

NPI number 1497784797
LBN Legal business name Bullis, Gregory
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2006
Last updated Nov 1st, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497784797 NPPES
Illinois MEDICAID 36067306

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