MICHELLE BOLANO (NPI# 1750580049) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750580049 |
| Entity Type | Individual |
| Full Name | MICHELLE BOLANO |
| Credential | D.P.T. |
| Practice Address |
1800 Hollister Dr Suite 205 Libertyville IL 60048-5263 |
| Mailing Address |
530 Sheridan Rd Apt 2b Evanston IL 60202-3119 |
| Practice Telephone | 8479187947 |
| Mailing Telephone | 8472047919 |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2007-07-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1800 HOLLISTER DR SUITE 205 |
| City | LIBERTYVILLE |
| State | IL |
| Zip Code | 60048-5263 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508862384 | Ronald Lee Freeman | Ophthalmology | 1800 Hollister Dr, Suite 205, Libertyville, IL 60048-3253 | 2005-06-25 |
| 1679957518 | Dana Beth Cohen | Social Worker | 1800 Hollister Dr, Suite 201, Libertyville, IL 60048-5263 | 2015-07-09 |
| 1063833796 | Diane M Bailey Yoder | Counselor | 1800 Hollister Dr, Suite 201, Libertyville, IL 60048-5263 | 2013-12-24 |
| 1053755538 | Jenny M. Siddiqi | Psychologist | 1800 Hollister Dr, Suite 201, Libertyville, IL 60048-5263 | 2013-04-26 |
| 1649583501 | Megan Claire Kawadza | Occupational Therapist | 1800 Hollister Dr, Ste 205, Libertyville, IL 60048-5263 | 2010-07-21 |
| 1417277930 | Erika Lynch | Physician Assistant | 1800 Hollister Dr, Ste 102, Libertyville, IL 60048-5263 | 2010-06-07 |
| 1669625406 | Marisa Maria Kunz | Psychologist | 1800 Hollister Dr, Libertyville, IL 60048-5263 | 2008-10-24 |
| 1720252323 | Elizabeth Ann Cole | Physical Therapist | 1800 Hollister Dr, 205, Libertyville, IL 60048-5263 | 2008-04-15 |
| 1033381140 | Gurnee Radiology Center, LLC | Radiology | 1800 Hollister Dr, Suite G-10, Libertyville, IL 60048-5263 | 2008-03-28 |
| 1477749430 | Elizabeth K Baruffi | Physician Assistant | 1800 Hollister Dr, Suite 102, Libertyville, IL 60048-5263 | 2007-09-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184119950 | Park Avenue Dental Professionals, PC | Dentist | 1001 W. Park Avenue, Libertyville, IL 60048 | 2018-06-25 |
| 1437643525 | Shanna Coyle | Registered Nurse | 1128 Jaimee Ln, Libertyville, IL 60048 | 2018-06-21 |
| 1366943672 | Jackie Rayyan | Behavior Technician | 917 Sherwood Drive, Suite 201, Lake Bluff, IL 60048 | 2018-02-22 |
| 1851804850 | Mary E. Linsey | Counselor | 34180 Highway 45, Libertyville, IL 60048 | 2017-11-13 |
| 1962929018 | Affinity Integrated Healthcare | Chiropractor | 736 Florsheim Dr, St 12, Libertyville, IL 60048 | 2017-08-29 |
| 1164946471 | Christianna Patterson | Speech-Language Pathologist | 1870 W Winchester Rd #203, Libertyville, IL 60048 | 2017-07-28 |
| 1962938407 | Kyle Winiger | Specialist/Technologist | 4551 West Gavin Lane, Libertyville, IL 60048 | 2017-05-03 |
| 1396291530 | Karyn Kolner | Physical Therapist | 860 W Winchester Rd, #108, Libertyville, IL 60048 | 2016-08-28 |
| 1477900785 | Medlogic LLC | Clinic/Center | 114 West Rockland Road, Suite 201, Libertyville, IL 60048 | 2016-05-17 |
| 1477926343 | Robert Mcnulty | Student in an Organized Health Care Education/Training Program | 1313 Crane Blvd, Libertyville, IL 60048 | 2015-11-02 |
| Find all providers in zip 60048 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477926343 | Robert Mcnulty | Student in an Organized Health Care Education/Training Program | 1313 Crane Blvd, Libertyville, IL 60048 | 2015-11-02 |
| 1639781107 | Ashley May York | Student in an Organized Health Care Education/Training Program | 1641 N Milwaukee Ave Ste 7, Libertyville, IL 60048-1350 | 2020-08-17 |
| 1255986857 | Lizzette Arcos | Student in an Organized Health Care Education/Training Program | 1113 S Milwaukee Ave, Libertyville, IL 60048-3758 | 2019-08-09 |
| 1215419320 | Lindsay Nicole Bishop | Student in an Organized Health Care Education/Training Program | 1113 S Milwaukee Ave, Libertyville, IL 60048-3758 | 2018-09-05 |
| 1184104770 | Catherine Lois Hoff | Student in an Organized Health Care Education/Training Program | 1641 N Milwaukee Ave Ste 7, Libertyville, IL 60048-1350 | 2018-08-14 |
| 1538666078 | Christopher Bernard Girardo | Student in an Organized Health Care Education/Training Program | 422 Broadway St, Libertyville, IL 60048-2321 | 2018-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720436 | April Renee Gallik | Student in an Organized Health Care Education/Training Program | 8807 S 79th Ave Apt 18, Hickory Hills, IL 60457-1597 | 2020-11-03 |
| 1932709706 | Samantha Klosak | Student in an Organized Health Care Education/Training Program | 8144 Old Mill Rd, Frankfort, IL 60423-8675 | 2020-10-29 |
| 1508466624 | Carly Belle Mitchell | Student in an Organized Health Care Education/Training Program | 870 Appletree Ct, Northbrook, IL 60062-3402 | 2020-10-28 |
| 1144829813 | Payton Collins | Student in an Organized Health Care Education/Training Program | 5103 S Brookstone Dr, Rochelle, IL 61068-9131 | 2020-10-22 |
| 1821697830 | Mayuri Prashant Shende | Student in an Organized Health Care Education/Training Program | 2160 S. First Ave., Bldg. 105, Suite 2840a, Marywood, IL 60135 | 2020-10-21 |
| 1922607001 | Katherine Chen | Student in an Organized Health Care Education/Training Program | 2305 Mohawk Ln, Glenview, IL 60026-1035 | 2020-10-20 |
| 1922606995 | Cassia Yuechun Weigel | Student in an Organized Health Care Education/Training Program | 601 N Main St Apt 5s, Normal, IL 61761-1576 | 2020-10-13 |
| 1679171888 | Manuel J Ramirez | Student in an Organized Health Care Education/Training Program | 714 W Woodland Rd, Lake Bluff, IL 60044-1652 | 2020-10-12 |
| 1205443975 | Nickolas Armstrong | Student in an Organized Health Care Education/Training Program | 2828 N Pine Grove Ave Apt 618, Chicago, IL 60657-6137 | 2020-09-28 |
| 1871109496 | Morgan Elizabeth Westjohn | Student in an Organized Health Care Education/Training Program | 111 Mound St, Sainte Marie, IL 62459 | 2020-09-18 |
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| City | LIBERTYVILLE |
| Zip Code | 60048 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.