Zachary Borgetti
Individual provider Active NPI Driver · Rockford, IL
NPI 1043028889 · NPPES record last updated Dec 26, 2024
Key facts
- NPI
- 1043028889
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 1919 11TH St
Rockford, IL 61104-5411 - Phone
- (815) 316-2572
- NPI assigned
- Dec 26, 2024
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | IL | Yes |
Addresses
Primary practice location
1919 11TH St
Rockford, IL 61104-5411
Mailing address
1919 11TH St
Rockford, IL 61104-5411
Phone (815) 316-2572
Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.