MEDICARE: YOLANDA ROLLINS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide

General Provider Information

NPI Number	:	1982158051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOLANDA ROLLINS

Provider Business Mailing Address
First Line	:	2855 W WILCOX ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3649
Country	:	US
Telephone Number	:	708-252-0927
Fax Number	:

Provider Business Practice Location Address
First Line	:	2855 W WILCOX ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3649
Country	:	US
Telephone Number	:	708-252-0927
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2016
Last Update Date	:	08/06/2016

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Directions to “ YOLANDA ROLLINS ” Practice Location

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