Individual
JOHN C ROLLET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
125 E PLUMMER BLVD STE A, CHATHAM, IL 62629-8136
(217) 483-3333
(217) 483-4393
Mailing address
125 E PLUMMER BLVD STE A, CHATHAM, IL 62629-8136
(217) 483-3333
(217) 483-4393
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036064761
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008540
HEALTH ALLIANCE
IL
01
—
020057300
BLACK LUNG
IL
01
—
036064761
IL STATE LICENSE
IL
05
—
036064761
—
IL
01
—
08421024
BC/BS
IL
01
—
100940
HEALTHLINK
IL
01
—
133586700
ACS-OWCP
IL
01
—
14D0435365
CLIA
IL
01
—
222697
PERSONAL CARE
IL
01
—
6394P
CATERPILLAR
IL
01
—
CD7143
RR MEDICARE GROUP
IL
01
—
P00149037
RR MEDICARE PIN
IL
Enumeration date
08/09/2006
Last updated
12/30/2021
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