Provider Demographics
NPI:1174165096
Name:ALIGNO, MICHAEL BOLADAS (MSN, APN, FNP-BC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:BOLADAS
Last Name:ALIGNO
Suffix:
Gender:M
Credentials:MSN, APN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 COUNTRYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60490-5459
Mailing Address - Country:US
Mailing Address - Phone:630-890-7503
Mailing Address - Fax:
Practice Address - Street 1:727 COUNTRYSIDE DR
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60490-5459
Practice Address - Country:US
Practice Address - Phone:630-890-7503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-11
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.020090363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily