Northern Illinois Medical Group S. C.

NPI #1861670101 in Rockford, Illinois

Provider Information

NPI Number: 1861670101
Entity Type: Organization
Organization Name: Northern Illinois Medical Group S. C.
Primary Specialty: Family Medicine
Enumeration Date: Feb 8, 2008
Last Updated: Oct 28, 2013

Practice Location

Address: 5301 E STATE ST STE 101
City: Rockford
State: Illinois
ZIP Code: 61108-2388
Phone: (815) 397-8500

Authorized Official

Name: DR. ANDREW KONG, D.C.
Title: OWNER
Phone: (815) 397-8500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X
Anesthesiology	207L00000X
Family Medicine	207Q00000X	Primary

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