MEDICARE: DR. WARREN L LOWRY M.D.,

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	036038948	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	791342073	OTHER	IL	RAILROAD MEDICARE PALMETT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	10120361	OTHER	IL	BLUE CROSS BLUE SHEILD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679561674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WARREN L LOWRY M.D.,

Provider Business Mailing Address
First Line	:	1340 CHARLES ST
Second Line	:	SUITE 200
City	:	ROCKFORD
State	:	IL
Zip	:	61104-2200
Country	:	US
Telephone Number	:	815-397-6642
Fax Number	:	815-397-6659

Provider Business Practice Location Address
First Line	:	1340 CHARLES ST
Second Line	:	SUITE 200
City	:	ROCKFORD
State	:	IL
Zip	:	61104-2200
Country	:	US
Telephone Number	:	815-397-6642
Fax Number	:	815-397-6659

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	05/29/2008

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