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Contact Information

BRIAN W MECKLENBURG, MD
2202 HARLEM ROAD
SUITE 200
LOVES PARK, IL61111-2754
 Phone: 815-877-4848
 Fax: 815-654-3271
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
 

Critical Care Medicine

207LC0200X 05 Physician/Anesthesiology
Indicates primary specialty

NPI Profile & details for BRIAN W MECKLENBURG · (Male)

NPI Number 1912047085
Status Active
Credentials MD
Entity Individual
Enumeration date 02/07/2007
Last updated 01/13/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036.149788
  • VA License # 0101102755
  • IL Medicaid 036149788
Hospital affiliation(s)
  • SWEDISH AMERICAN HOSPITAL - (Acute Care)
    1401 EAST STATE STREET
    ROCKFORD, IL 61104
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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