Blank, Jeffrey

Blank, Jeffrey is an sole proprietor health care provider with primary practice located at 31 W Dundee Rd , Wheeling IL 60090-4863. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Blank, Jeffrey can be contacted via phone (847) 215-1525.

Contact Information

Primary practice address
31 W Dundee Rd Wheeling IL 60090-4863
Phone: (847) 215-1525
Fax: (312) 642-9311
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 016004427 Illinois
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X PO 2074 Florida

Profile Details

NPI number 1235142605
LBN Legal business name Blank, Jeffrey
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 15th, 2006
Last updated Feb 1st, 2016 - about 8 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 1235142605 NPPES
Illinois Other 480015544 RAILROAD MEDICARE
Illinois Other 200820 RAILROAD MEDICARE

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