Eggers, Gordon

Eggers, Gordon is an individual health care provider with primary practice located at 1200 W State St , Rockford IL 61102-2112. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Eggers, Gordon can be contacted via phone (815) 490-1600.

Contact Information

Primary practice address
1200 W State St Rockford IL 61102-2112
Phone: (815) 490-1600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 0085000278 Illinois

Profile Details

NPI number 1033192927
LBN Legal business name Eggers, Gordon
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 23rd, 2005
Last updated Jul 9th, 2007 - about 18 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 1033192927 NPPES
Illinois MEDICAID 0085000278

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