| Dr Mariano Villalon Tolentino Jr, MD | |
|
2502 E Empire St, Bloomington, IL 61704-3738 | |
| (309) 661-3380 | |
| (309) 661-3318 |
| Full Name | Dr Mariano Villalon Tolentino Jr |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 46 Years |
| Location | 2502 E Empire St, Bloomington, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356315626 | NPI | - | NPPES |
| 036075928 | Medicaid | IL | |
| 005007705 | Other | IL | BC/BS |
| 364121826 | Other | IL | JOHN DEERE |
| 018416 | Other | IL | HEALTH ALLIANCE |
| 0080670003 | Other | IL | DME |
| 340013998 | Other | IL | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 036075928 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Joseph Medical Center | Bloomington, IL | Hospital |
| Advocate Bromenn Medical Center | Normal, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Christie Clinic, Pllc | 7719899319 | 210 |
| Entity Name | Christie Clinic, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871523829 PECOS PAC ID: 7719899319 Enrollment ID: O20031103000332 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mariano Villalon Tolentino Jr, MD 101 W University Ave, Champaign, IL 61820-3981 Ph: (309) 661-3380 | Dr Mariano Villalon Tolentino Jr, MD 2502 E Empire St, Bloomington, IL 61704-3738 Ph: (309) 661-3380 |
Dr. Benjamin J Leak, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 1401 Eastland Dr, Suite B, Bloomington, IL 61701 Phone: 309-663-9424 Fax: 309-663-6350 | |
Dr. Scott Christopher Morgan, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 2502 E Empire St, Bloomington, IL 61704 Phone: 309-661-3380 Fax: 309-661-3318 | |
Dr. Thomas B Kulb, M.D., Urology Medicare: Not Enrolled in Medicare Practice Location: 1401 Eastland Dr, Suite B, Bloomington, IL 61701 Phone: 309-663-9424 Fax: 309-663-6350 | |
Dr. Vicken S Chalian, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 1401 Eastland Dr, Suite B, Bloomington, IL 61701 Phone: 309-663-9424 Fax: 309-663-6350 |