Individual
DAVE BOLGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4901 W 79TH ST, 2ND FLOOR, BURBANK, IL 60459-1554
(708) 499-1545
(708) 499-4862
Mailing address
4901 W 79TH ST, 2ND FLOOR, BURBANK, IL 60459-1554
(708) 499-1545
(708) 499-4862
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036135786
IL
Other
Enumeration date
06/01/2011
Last updated
08/05/2014
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