Most Relevant Information
Provider Data
| NPI Number: | 1003372855 |
| Provider Name: | LOGAN JOHN CHAPMAN-NEAL |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/18/2019 |
| Last Updated: | 02/18/2019 |
Provider Practice Location
1601 UNIVERSITY DR
ROCKFORD
IL
611075317
Practice Location Phone/Fax
| Phone: | 8153911000 |
| Fax: |
Provider Mailing Location
1021 N MULFORD RD
ROCKFORD
IL
611073877
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |