Paul Bolger

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036100563 Issued in IL

Practice address

2701 17TH St
Rock Island, IL 61201-5351

Phone

(309) 779-5000

NPI assigned

Feb 8, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2018 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bolger Aesthestics, PC

  • Health Service Clinic/Center
  • Davenport, IA
  • NPI 1124449780
  NPD (past) Authorized official
• Advocate North Side Health Network

  • Institutional Pharmacy
  • Chicago, IL
  • NPI 1114645470
  NPD (past)
• Mendota Community Hospital

  • Rural Health Clinic/Center
  • Granville, IL
  • NPI 1225877590
  NPD (past)
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192838400000",
    "number": "1376516609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 17TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015351",
            "telephone_number": "309-779-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 17TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015351",
            "telephone_number": "309-779-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLGER",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2007-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036100563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0571026",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC WELLMARK 7TH",
            "identifier": "98357",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036100563008",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC WELLMARK WEST",
            "identifier": "98356",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "IL0181",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2571026",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00040958",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelsie Blaesing
• Charles Rueben Blake III
• Cassandra Lynn Blondeau, BSW
• Mary Jo Bloominger, PA
• Sidney G Boersma, LCSW
• Kaitlyn Marie Bonner, DPT
• Andrew William Boswell, D.C.
• Joseph Anthony Bowen, HEALTH TECHNICIAN
• Elijah Jamison Bowers
• Judy Bowers

• Emergency Medicine Physician in Rock Island, IL
• Providers in Rock Island, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.