Provider Demographics
NPI:1982606745
Name:RAUTER, MARK A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:RAUTER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2350 N ROCKTON AVE
Mailing Address - Street 2:BRAIN AND SPINE CENTER
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61103-3619
Mailing Address - Country:US
Mailing Address - Phone:815-971-2000
Mailing Address - Fax:815-963-3428
Practice Address - Street 1:2350 N ROCKTON AVE
Practice Address - Street 2:SUITE 510
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61103-3600
Practice Address - Country:US
Practice Address - Phone:815-971-2000
Practice Address - Fax:815-963-3428
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2010-12-10
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Provider Licenses
StateLicense IDTaxonomies
IL036050137208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL748201Medicare ID - Type Unspecified
ILC43192Medicare UPIN