DALE GRAY M.D.,S.C.
Ambulatory Health at Glenwood Ct, Rockford, IL

License number
Illinois 036072289
Category
Ambulatory Health
Type
Primary Care
Owner
Name: DR. DALE GRAY MD
Title: PRESIDENT
Phone: (815) 962-0633
Address
Address
2720 Glenwood Ct, Rockford, IL 61101
National Provider ID: 1750807558
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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DALE GRAY M.D., S.C

Rockford, IL 61103

Registration:
Jan 17, 2001
State ID:
61420789
Business type:
Domestic Bca
Expiration:
Perpetual
Agent:
John D Lanpher,2601 Reid Farm Rd SUITE B, Rockford, IL 61114 (Physical)

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