Healthcare Provider Details

I. General information

NPI: 1306440714
Provider Name (Legal Business Name): JULIE CATHERINE ROLLINS NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2020
Last Update Date: 11/23/2021
Certification Date: 11/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 SILVER CROSS BLVD
NEW LENOX IL
60451-9509
US

IV. Provider business mailing address

1042 MAPLE AVE STE 335
LISLE IL
60532-2329
US

V. Phone/Fax

Practice location:
  • Phone: 815-300-5376
  • Fax: 815-300-4848
Mailing address:
  • Phone: 708-829-2198
  • Fax: 630-818-2998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209022233
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number209022233
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: