Most Relevant Information
Provider Data
| NPI Number: | 1003499278 |
| Provider Name: | ANTHONY ENRICO |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 041442697 |
Most Important Dates
| Enumeration Date: | 05/04/2021 |
| Last Updated: | 12/28/2021 |
Provider Practice Location
5666 E STATE ST
ROCKFORD
IL
611082425
Practice Location Phone/Fax
| Phone: | 8152262000 |
| Fax: |
Provider Mailing Location
1911 RIDGELAND RD
ROCKFORD
IL
611086321
Provider Mailing Phone/Fax
| Phone: | 8157138107 |
| Fax: |