Holt, Ronald

Holt, Ronald is an sole proprietor health care provider with primary practice located at 2800 W 95Th St , Evergreen Park IL 60805-2746. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Ambulatory Health Care Facilities / Multi-Specialty, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medical Services is his primary health care specialty. Holt, Ronald can be contacted via phone (708) 422-4221.

Contact Information

Primary practice address
2800 W 95Th St Evergreen Park IL 60805-2746
Phone: (708) 422-4221
Fax: (708) 422-4415
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 036066295 Illinois
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X 036066295 Illinois
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036.066295 Illinois

Profile Details

NPI number 1295718781
LBN Legal business name Holt, Ronald
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 29th, 2005
Last updated Feb 24th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295718781 NPPES
Illinois Other 036033295 BLUE CROSS BLUE SHIELD
Illinois MEDICAID 036066295 BLUE CROSS BLUE SHIELD

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