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General NPI Number Information
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NPI Number | 1558337956
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Entity Type | Individual
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Provider Name | TAMMY J HOMMAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/24/2006
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Last Update Date | 11/01/2023
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Provider Practice Location Address
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Address Line | 1221 E STATE ST
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City | ROCKFORD
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State | IL
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Zip | 61104-2231
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Country | US
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Telephone | 815-972-1000
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Fax | 815-972-1086
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Provider Business Mailing Address
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Address Line | 1601 PARKVIEW AVENUE CREDENTIALING S200C
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City | ROCKFORD
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State | IL
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Zip | 61107
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Country | US
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Telephone | 815-395-5861
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Fax | 815-395-5575
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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 | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 036108049
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 036108049
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036-108049
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License Number State | IL
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