| Dr Roland A Tolliver Jr, DPM | |
|
Freeport Podiatry Services, Llc, 1201 West Empire Street, Freeport, IL 61032-6106 | |
| (815) 232-8015 | |
| (815) 235-1376 |
| Full Name | Dr Roland A Tolliver Jr |
|---|---|
| Gender | Male |
| Speciality | Podiatrist - Foot & Ankle Surgery |
| Location | Freeport Podiatry Services, Llc, Freeport, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992891410 | NPI | - | NPPES |
| 0060201289 | Other | IL | BCBS |
| 016003850 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 016003850 (Illinois) | Primary |
| Provider Name | Freeport Regional Health Care Foundation |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1457337016 PECOS PAC ID: 9234041682 Enrollment ID: O20031104000182 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Roland A Tolliver Jr, DPM Freeport Podiatry Services, Llc, 1201 West Empire Street, Freeport, IL 61032-6106 Ph: (815) 232-8015 | Dr Roland A Tolliver Jr, DPM Freeport Podiatry Services, Llc, 1201 West Empire Street, Freeport, IL 61032-6106 Ph: (815) 232-8015 |
Carol Ann Wisniewski, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 521 W Main St, Freeport, IL 61032 Phone: 815-233-0211 Fax: 815-233-0214 | |
Kenneth S Stone Dpm Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 1717 W Church St, Freeport, IL 61032 Phone: 815-235-4231 Fax: 815-233-9531 | |
Roland A. Tolliver Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 1201 W Empire St, Freeport, IL 61032 Phone: 815-232-8015 Fax: 815-235-1376 | |
Ronald Keith Dickey, DPM Podiatrist Medicare: Medicare Enrolled Practice Location: 521 W Main St, Freeport, IL 61032 Phone: 815-233-0211 Fax: 815-233-0214 | |
Northern Illinois Podiatry Pc Podiatrist Medicare: Medicare Enrolled Practice Location: 521 W Main St, Freeport, IL 61032 Phone: 815-233-0211 Fax: 815-233-0214 |