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General NPI Number Information
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NPI Number | 1548682990
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Entity Type | Organization
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Legal Business Name | REPRODUCTIVE SOLUTIONS LLC
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Dates
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Enumeration Date | 01/19/2014
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Last Update Date | 01/19/2014
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Provider Practice Location Address
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Address Line | 435 N MULFORD RD STE 9
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City | ROCKFORD
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State | IL
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Zip | 61107-5100
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Country | US
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Telephone | 815-229-1700
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Fax | 815-229-1831
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Provider Business Mailing Address
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Address Line | 435 N MULFORD RD STE 9
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City | ROCKFORD
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State | IL
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Zip | 61107-5100
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Country | US
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Telephone | 815-229-1700
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Fax | 815-229-1831
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Authorized Official
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Title or Position | PRESIDENT
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Name | TODD D DEUTCH
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Credential | M.D.
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Telephone | 815-229-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number | 036111547
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License Number State | IL
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