Individual
DR. PAUL BOLGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-5000
Mailing address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-5000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036100563
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036100563008
—
IL
05
—
0571026
—
IL
05
—
2571026
—
IL
01
—
98356
BC WELLMARK WEST
IL
01
—
98357
BC WELLMARK 7TH
IL
01
—
IL0181
JOHN DEERE
IL
01
—
P00040958
RR MEDICARE
—
Enumeration date
02/08/2006
Last updated
10/20/2007
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