Okeson, Edwin

Okeson, Edwin 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 Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Okeson, Edwin 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:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036067805 Illinois

Profile Details

NPI number 1619951019
LBN Legal business name Okeson, Edwin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2005
Last updated May 5th, 2010 - about 16 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 1619951019 NPPES
Illinois MEDICAID 036067805

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