Blanks, Richard

Blanks, Richard is an individual health care provider with primary practice located at 1802 S Mattis Ave , Champaign IL 61821-5923. He recently has only one registered license in Allopathic & Osteopathic Physicians / Forensic Psychiatry, which is considered as his primary health care specialty. Blanks, Richard can be contacted via phone (217) 383-1850.

Contact Information

Primary practice address
1802 S Mattis Ave Champaign IL 61821-5923
Phone: (217) 383-1850
Fax: (217) 383-3439
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Forensic Psychiatry 2084F0202X 223476 Massachusetts

Profile Details

NPI number 1669521480
LBN Legal business name Blanks, Richard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2007
Last updated Jan 20th, 2021 - about 4 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 1669521480 NPPES
South Carolina Other Q0024X SC MEDICAID
South Carolina Other 1669521480 SC MEDICAID
South Carolina Other 1669521480 SC MEDICAID
South Carolina Other 1669521480 SC MEDICAID
South Carolina MEDICAID 1669521480 SC MEDICAID
South Carolina Other 277884 SC MEDICAID
South Carolina Other 9323083 SC MEDICAID
South Carolina Other 1669521480 SC MEDICAID
South Carolina Other 185TN SC MEDICAID
South Carolina Other 1669521480 SC MEDICAID
South Carolina Other 1669521480 SC MEDICAID
South Carolina Other 3021917 SC MEDICAID

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