Susan Provow, M.D.

NPI #1861580128 in Rock Falls, Illinois

Provider Information

NPI Number: 1861580128
Entity Type: Individual
Name: Susan Provow, M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Family Medicine
Credential: M.D.
Enumeration Date: Oct 11, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 100 W 1ST ST
City: Rock Falls
State: Illinois
ZIP Code: 61071-1269
Phone: (815) 625-4790

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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