National Provider Identifier Database

SUSAN M FOWELL, MD – NPI #1821091075
Retina Specialist

An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.


Contact Information

SUSAN M FOWELL, MD
1235 N MULFORD RD
SUITE 100
ROCKFORD, IL61107-3879
Phone: 815-226-4990
Fax: 815-226-9472
Website:
Specialty Taxonomy Code
* Retina Specialist 207WX0107X
Ophthalmology 207W00000X

* Indicates primary specialty

NPI Profile & details for SUSAN M FOWELL

NPI Number 1821091075
Credentials MD
Entity Individual
Enumeration date 05/23/2005
Last updated 07/06/2017 - About 9 years ago
Sole proprietor1 Yes
Identifiers
  • IL License #: 036073359
  • IL Medicaid: 036073359
  • IL Other: 036073359 IL STATE LICENSE #
  • IL Other: 363734974 TAX ID#
Hospital affiliation n/a

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.

Reviews for SUSAN M FOWELL, MD

There are currently no reviews for SUSAN M FOWELL, MD


NPIdb - Home
v2.201