# JOHN C ROLLET

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1932119112
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 036064761 | IL | Yes |

## Other

- **Enumeration date:** 08/09/2006
- **Last updated:** 12/30/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 008540 | HEALTH ALLIANCE | IL |
| 01 | — | 020057300 | BLACK LUNG | IL |
| 01 | — | 036064761 | IL STATE LICENSE | IL |
| 05 | — | 036064761 | — | IL |
| 01 | — | 08421024 | BC/BS | IL |
| 01 | — | 100940 | HEALTHLINK | IL |
| 01 | — | 133586700 | ACS-OWCP | IL |
| 01 | — | 14D0435365 | CLIA | IL |
| 01 | — | 222697 | PERSONAL CARE | IL |
| 01 | — | 6394P | CATERPILLAR | IL |
| 01 | — | CD7143 | RR MEDICARE GROUP | IL |
| 01 | — | P00149037 | RR MEDICARE PIN | IL |