Tolentino, Mariano Villalon

Tolentino, Mariano Villalon is an individual health care provider with primary practice located at 1701 E College Ave , Bloomington IL 61704-2101. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Tolentino, Mariano Villalon can be contacted via phone (309) 664-3000.

Contact Information

Primary practice address
1701 E College Ave Bloomington IL 61704-2101
Fax: (309) 664-3026
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 036075928 Illinois

Profile Details

NPI number 1356315626
LBN Legal business name Tolentino, Mariano Villalon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 14th, 2006
Last updated Mar 17th, 2014 - about 10 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 1356315626 NPPES
Illinois Other 018416 HEALTH ALLIANCE
Illinois MEDICAID 036075928 HEALTH ALLIANCE
Illinois Other 364121826 HEALTH ALLIANCE
Illinois Other 005007705 HEALTH ALLIANCE
Illinois Other 340013998 HEALTH ALLIANCE
Illinois Other 0080670003 HEALTH ALLIANCE

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