Organization
J.E.BERTOLINI ,M.D. SC.
Active
Other names
ADVANTACARE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY E BERTOLINI M.D. (PRESIDENT)
(815) 741-4104
Entity
Organization
Contact information
Practice address
202 N HAMMES AVE, SUITE D, JOLIET, IL 60435-8129
(815) 741-4104
(815) 741-4135
Mailing address
202 N HAMMES AVE, SUITE D, JOLIET, IL 60435-8129
(815) 741-4104
(815) 741-4135
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XP3100X
Pediatric Orthopaedic Surgery Physician
—
—
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
207XX0801X
Orthopaedic Trauma Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036057862
—
IL
Enumeration date
04/09/2008
Last updated
11/13/2008
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