Individual
MARYBETH BOLANOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1801 S HIGHLAND AVE STE 220, LOMBARD, IL 60148-4932
(630) 790-1872
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085001424
IL
363AS0400X
Surgical Physician Assistant
085001424
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085001424
—
IL
01
—
970023229
RAILROAD MEDICARE
IL
Enumeration date
09/27/2005
Last updated
06/27/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us