Provider Demographics
NPI:1104124411
Name:JAVIER, ROLANDO SR
Entity type:Individual
Prefix:MR
First Name:ROLANDO
Middle Name:
Last Name:JAVIER
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1686 HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60018-3022
Mailing Address - Country:US
Mailing Address - Phone:630-540-6440
Mailing Address - Fax:847-321-9257
Practice Address - Street 1:1686 HOWARD AVE
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60018-3022
Practice Address - Country:US
Practice Address - Phone:630-540-6440
Practice Address - Fax:847-321-9257
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)