Dr. Thomas Joseph Bollaert
Family Doctor Family Doctor - Sports Medicine
3904 16th St
Moline
, Illinois 61265-1275
Dr. Thomas Joseph Bollaert
Family Doctor Family Doctor - Sports Medicine
3904 16th St
Moline
, Illinois 61265-1275
(309) 581-7600
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About
Features
Specialties
- Family Doctor
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Dr. Thomas Joseph Bollaert
- 3904 16th St
- Moline, IL
- Zip : 61265-1275
- Phone : (309) 581-7600
Second Address
- Dr. Thomas Joseph Bollaert
- 3904 16th St
- Moline, IL
- Zip : 61265-1275
- Phone : (309) 581-7600
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207Q00000X | Family Doctor | 125069405 | IL |
| Y | 207QS0010X | Family Doctor - Sports Medicine | 036.154509 | IL |
National Provider Identifier
| NPI | 1245680651 |
|---|---|
| Provider Name | Dr. Thomas Joseph Bollaert |
| First Address | Moline, IL 61265-1275 |
| Second Address | Moline, IL 61265-1275 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/06/2016 |
| Last Update Date | 19/01/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.