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ROLAND A. TOLLIVER NPI 1578752796


NPI Information

NPI: 1578752796
Provider Name: ROLAND A. TOLLIVER

Doing Business As: FREEPORT PODIATRY SERVICES, LLC

Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
1201 W EMPIRE ST
FREEPORT, IL
ZIP 61032
Phone: (815) 232-8015
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ROLAND A. TOLLIVER is a foot and ankle surgery podiatrist in Freeport, IL. ROLAND A. TOLLIVER NPI is 1578752796. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Freeport Podiatry Services, Llc.

The provider's business location address is:

1201 W EMPIRE ST
FREEPORT, IL
ZIP 61032-106
Phone: (815) 232-8015
Fax: (815) 235-1376

The provider's authorized official is Roland A Tolliver .
The authorized official title is Member and has the following contact phone number (815) 232-8015.

The enumeration date for this NPI number is 10/24/2007 and was last updated on 6/12/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213ES0103XPodiatristFoot & Ankle Surgery016003850ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1346570MEDICARE PINILLINOIS
2T38801MEDICARE UPINILLINOIS
30060201289OTHERILLINOISBLUE CROSS BLUE SHIELD
4016003850MEDICAIDILLINOIS
54456080001MEDICARE NSCILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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