Physician Assistant
MICAH CLUTTER
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1053948521 · enumerated 2020-03-25 · record updated 2020-07-30. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Addresses and phones
- Practice location 324 ROXBURY RD, ROCKFORD, IL, 61107-5090 (815) 398-9491 Fax (815) 381-7498 Google Maps Apple Maps OpenStreetMap
- Mailing address BOX 78534, MILWAUKEE, WI, 53278-8534 (815) 398-9491 Fax (815) 381-7498 Google Maps Apple Maps OpenStreetMap
Specialties
- Specialist/Technologist, Athletic Trainer 2255A2300X
- Physician Assistant 363A00000X · Primary · License 085-007766 IL
In this directory
Locations and evidence
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Practice location
ROCKFORD, IL, 611075090
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.