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Contact Information

MARGARET PROVENZA
1253 N ALPINE RD
ROCKFORD, IL61107
 Phone: 779-696-9201
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for MARGARET PROVENZA · (Female)

NPI # 1457378283
Status Active
Credentials
Entity Individual
Enumeration date 07/17/2006
Last updated 02/19/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036072887
  • IL Medicaid 036072887
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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