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Individual
ROLANDO HENRIQUEZ
Active
Individual
ROLANDO HENRIQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036087152
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036087152
—
IL
01
—
2205538
BCBS OF ILLINOIS
IL
01
—
363950044
TAX ID
IL
Enumeration date
01/12/2007
Last updated
05/04/2012
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