Healthcare Provider Details

I. General information

NPI: 1295798742
Provider Name (Legal Business Name): GEORGE A ZAVERDAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 02/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 ROXBURY RD
ROCKFORD IL
61107-5059
US

IV. Provider business mailing address

444 ROXBURY RD
ROCKFORD IL
61107-5059
US

V. Phone/Fax

Practice location:
  • Phone: 815-398-3000
  • Fax: 815-391-5096
Mailing address:
  • Phone: 815-398-3000
  • Fax: 815-391-5096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036-063061
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: