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General NPI Number Information
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NPI Number | 1144753062
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Entity Type | Individual
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Provider Name | LUQMAN BALOCH M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/07/2017
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 8201 E RIVERSIDE BLVD
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City | ROCKFORD
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State | IL
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Zip | 61114-2300
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Country | US
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Telephone | 815-971-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 10400 HALIGUS RD
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City | HUNTLEY
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State | IL
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Zip | 60142-9553
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Country | US
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Telephone | 815-759-4323
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Fax | 815-759-4948
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 036152762
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 227887
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 036152762
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036152762
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License Number State | IL
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