Individual
DR. THOMAS JOSEPH BOLLAERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6000 N ALLEN RD, PEORIA, IL 61614-3294
(309) 691-1400
Mailing address
6000 N ALLEN RD, PEORIA, IL 61614-3294
(309) 691-1400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
125069405
IL
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
036.154509
IL
Other
Enumeration date
06/16/2016
Last updated
10/02/2024
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