Provider Demographics
NPI:1568025872
Name:HOPKINS FAMILY MED & URGENT CARE, PLLC
Entity type:Organization
Organization Name:HOPKINS FAMILY MED & URGENT CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FIKISHA
Authorized Official - Middle Name:LATOYA
Authorized Official - Last Name:WARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-708-0116
Mailing Address - Street 1:4857 MANHATTAN DR
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61108-2265
Mailing Address - Country:US
Mailing Address - Phone:815-708-0116
Mailing Address - Fax:815-708-0174
Practice Address - Street 1:4857 MANHATTAN DR
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108-2265
Practice Address - Country:US
Practice Address - Phone:815-708-0116
Practice Address - Fax:815-708-0174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-22
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL248.002545OtherIDFPR