Healthcare Provider Details

I. General information

NPI: 1811383573
Provider Name (Legal Business Name): IRENA MARKOVIC M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: IRENA ZIVKOVIC

II. Dates (important events)

Enumeration Date: 04/09/2015
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5666 E STATE ST
ROCKFORD IL
61108-2425
US

IV. Provider business mailing address

5666 E STATE ST
ROCKFORD IL
61108-2425
US

V. Phone/Fax

Practice location:
  • Phone: 815-226-2000
  • Fax:
Mailing address:
  • Phone: 815-226-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036.147306
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036.147306
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: