Jack Peter Kotlarz, MD

NPI #1922090646 in Rockford, Illinois

Provider Information

NPI Number: 1922090646
Entity Type: Individual
Name: Jack Peter Kotlarz, MD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Otolaryngology - Plastic Surgery within the Head & Neck
Credential: MD
Enumeration Date: Aug 18, 2005
Last Updated: Dec 10, 2024

Practice Location

Address: 1253 N ALPINE RD
City: Rockford
State: Illinois
ZIP Code: 61107-2201
Phone: (779) 696-9201

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X
Otolaryngology	207Y00000X
Otolaryngology - Plastic Surgery within the Head & Neck — Plastic Surgery within the Head & Neck	207YX0007X	Primary

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