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General NPI Number Information
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NPI Number | 1326064940
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Entity Type | Organization
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Legal Business Name | WARREN L LOWRY SC
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 12/17/2012
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Provider Practice Location Address
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Address Line | 1340 CHARLES ST SUITE 200
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City | ROCKFORD
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State | IL
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Zip | 61104-2200
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Country | US
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Telephone | 815-397-6642
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Fax | 815-397-6659
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Provider Business Mailing Address
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Address Line | 1340 CHARLES ST SUITE 200
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City | ROCKFORD
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State | IL
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Zip | 61104-2200
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Country | US
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Telephone | 815-397-6642
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Fax | 815-397-6659
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WARREN L LOWRY
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Credential | MD
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Telephone | 815-397-6642
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 036038948
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License Number State | IL
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