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General NPI Number Information
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NPI Number | 1689604969
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Entity Type | Individual
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Provider Name | PRABHA CHAND DOSI M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 02/04/2010
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Provider Practice Location Address
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Address Line | 1401 E. STATE STREET
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City | ROCKFORD
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State | IL
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Zip | 61104
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Country | US
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Telephone | 815-489-4177
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Fax | 815-490-5906
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Provider Business Mailing Address
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Address Line | 2112 TIMBER TRAIL
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City | FREEPORT
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State | IL
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Zip | 61032-9388
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Country | US
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Telephone | 815-232-6822
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Fax | 815-490-5906
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 036067824
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License Number State | IL
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