Wang, Jeannie
Wang, Jeannie is an individual health care provider with primary practice located at 5970 Churchview Dr , Rockford IL 61107-2574. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Wang, Jeannie can be contacted via phone (815) 971-2000.Contact Information
Primary practice address
5970 Churchview Dr
Rockford IL 61107-2574
Phone: (815) 971-2000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 036098371 | Illinois |
Profile Details
| NPI number | 1487714002 |
|---|---|
| LBN Legal business name | Wang, Jeannie |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 12th, 2006 |
| Last updated | Jan 26th, 2010 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487714002 | NPPES |
| Illinois | MEDICAID | 036098371 |
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