Rollo, Derrick E

Rollo, Derrick E is an individual health care provider with primary practice located at 611 W Park St , Urbana IL 61801-2529. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Rollo, Derrick E can be contacted via phone (217) 383-3311.

Contact Information

Primary practice address
611 W Park St Urbana IL 61801-2529
Phone: (217) 383-3311
Fax: (217) 383-3463
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 125-051736 Illinois
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 02004004A Indiana
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036122306 Illinois

Profile Details

NPI number 1881891471
LBN Legal business name Rollo, Derrick E
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2007
Last updated Jan 19th, 2021 - about 3 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 1881891471 NPPES
Indiana MEDICAID 201060370
Indiana Other 000000761884

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