Provider Demographics
NPI:1740439215
Name:NOWAK, MAGDALENA (MD)
Entity type:Individual
Prefix:DR
First Name:MAGDALENA
Middle Name:
Last Name:NOWAK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3401 N PERRYVILLE RD
Mailing Address - Street 2:ROCKFORD HEALTH PHYSICIANS
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61114-8011
Mailing Address - Country:US
Mailing Address - Phone:815-971-2000
Mailing Address - Fax:815-972-1092
Practice Address - Street 1:3401 N PERRYVILLE RD
Practice Address - Street 2:ROCKFORD HEALTH PHYSICIANS
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61114-8011
Practice Address - Country:US
Practice Address - Phone:815-971-2000
Practice Address - Fax:815-972-1092
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
IL036127440207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program