Individual
JOHN A. POLLASTRINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1302 FRANKLIN AVE STE 1100, NORMAL, IL 61761-0016
(309) 268-2727
(309) 268-6513
Mailing address
PO BOX 2451, BLOOMINGTON, IL 61702-2451
(309) 268-2172
(309) 268-3649
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036073402
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036073402
—
IL
01
—
5723019
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/24/2006
Last updated
12/16/2021
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