Blandon, Roberta E
Blandon, Roberta E is an individual health care provider with primary practice located at 1875 Dempster St Ste 665 , Park Ridge IL 60068. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery, Allopathic & Osteopathic Physicians / Gynecology. Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery is her primary health care specialty. Blandon, Roberta E can be contacted via phone (847) 825-1590.Contact Information
Primary practice address
1875 Dempster St Ste 665
Park Ridge IL 60068
Phone: (847) 825-1590
Fax: (847) 825-1604
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 2001015985 | Missouri |
| Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery | 207VF0040X | 2001015985 | Missouri |
| Allopathic & Osteopathic Physicians / Gynecology | 207VG0400X | 036147113 | Illinois |
| Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery | 207VF0040X | 036147113 | Illinois |
Profile Details
| NPI number | 1669450011 |
|---|---|
| LBN Legal business name | Blandon, Roberta E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 5th, 2006 |
| Last updated | Aug 9th, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669450011 | NPPES |
| Texas | MEDICAID | L6224 | |
| Texas | MEDICAID | 2001015985 | |
| Texas | MEDICAID | 036147113 |
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