Individual
MR. BARTOLO ROA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
166 W MAPLE AVE, WAUCONDA, IL 60084-1818
(773) 556-5696
Mailing address
166 W MAPLE AVE, WAUCONDA, IL 60084-1818
(773) 556-5696
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
R00006075241
IL
Other
Enumeration date
12/12/2023
Last updated
12/12/2023
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