Individual
CARLA BOLEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
415 W FRONT ST, ROANOKE, IL 61561-7817
(309) 923-7456
Mailing address
701 LEE ST, SUITE 300, DES PLAINES, IL 60016-4539
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209004989
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
472312
HEALTHLINK
IL
01
—
7215059
BCBS PPO
IL
01
—
IL01X2
JOHN DEERE
IL
01
—
P00293738
RAILROAD MEDICARE
IL
Enumeration date
07/26/2006
Last updated
06/24/2013
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