Provider Demographics
NPI:1740246040
Name:ROWLAND, PAUL E (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:E
Last Name:ROWLAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 N WALL ST STE P420
Mailing Address - Street 2:
Mailing Address - City:KANKAKEE
Mailing Address - State:IL
Mailing Address - Zip Code:60901-3406
Mailing Address - Country:US
Mailing Address - Phone:815-932-0911
Mailing Address - Fax:815-932-0631
Practice Address - Street 1:375 N WALL ST STE P420
Practice Address - Street 2:
Practice Address - City:KANKAKEE
Practice Address - State:IL
Practice Address - Zip Code:60901-3406
Practice Address - Country:US
Practice Address - Phone:815-932-0911
Practice Address - Fax:815-932-0631
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036076921208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036076921Medicaid
IL123451234567OtherHEALTHLINK INC PPO ID
IL020011942OtherRAILROAD MEDICARE
IL123451234567OtherPREFERRED ONE ID
IL276853600OtherOWCP PROVIDER ID
IL4615036OtherBCBS PROVIDER ID