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Individual

DR. ROLAND A TOLLIVER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
FREEPORT PODIATRY SERVICES, LLC, 1201 WEST EMPIRE STREET, FREEPORT, IL 61032-6106
(815) 232-8015
(815) 235-1376
Mailing address
FREEPORT PODIATRY SERVICES, LLC, 1201 WEST EMPIRE STREET, FREEPORT, IL 61032-6106
(815) 232-8015
(815) 235-1376

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016003850
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0060201289
BCBS
IL
05
016003850
IL
Enumeration date
10/04/2006
Last updated
11/01/2007
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