Provider Demographics
NPI:1154506749
Name:ADVANCED REPRODUCTIVE CENTER, LTD.
Entity Type:Organization
Organization Name:ADVANCED REPRODUCTIVE CENTER, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:HOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-229-1700
Mailing Address - Street 1:435 N MULFORD RD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-5189
Mailing Address - Country:US
Mailing Address - Phone:815-229-1700
Mailing Address - Fax:815-229-1831
Practice Address - Street 1:435 N MULFORD RD
Practice Address - Street 2:SUITE 9
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-5189
Practice Address - Country:US
Practice Address - Phone:815-229-1700
Practice Address - Fax:815-229-1831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty