Provider Demographics
NPI:1003055765
Name:PALATOLON, ROJIE M (PT)
Entity Type:Individual
Prefix:MR
First Name:ROJIE
Middle Name:M
Last Name:PALATOLON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 E LYNN BLVD
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:IL
Mailing Address - Zip Code:61081-1085
Mailing Address - Country:US
Mailing Address - Phone:815-626-6630
Mailing Address - Fax:815-626-6796
Practice Address - Street 1:110 E LYNN BLVD
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:IL
Practice Address - Zip Code:61081-1085
Practice Address - Country:US
Practice Address - Phone:815-626-6630
Practice Address - Fax:815-626-6796
Is Sole Proprietor?:No
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070016826225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL09821954OtherBCBS