MEDICARE: KENNETH I BLUESTONE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	036138832	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00056031	OTHER	MO	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1326045568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH I BLUESTONE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 23229
Second Line	:
City	:	BELLEVILLE
State	:	IL
Zip	:	62223-0229
Country	:	US
Telephone Number	:	618-257-5050
Fax Number	:	618-233-1061

Provider Business Practice Location Address
First Line	:	4500 MEMORIAL DR
Second Line	:
City	:	BELLEVILLE
State	:	IL
Zip	:	62226-5360
Country	:	US
Telephone Number	:	618-257-4376
Fax Number	:	618-257-5196

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	03/15/2021

Similar Medicare Providers

1861749780 — DR. KENECHUKWU OLUFEMI CHUDY-ONWUGAJE M.D.
Practice Location Address:

4500 MEMORIAL DR
BELLEVILLE, IL
62226-5360

Practice Phone: 618-257-6220
Practice Fax:

1598757031 — DR. DAVID JEFFREY EISENSTEIN MD
Practice Location Address:

4500 MEMORIAL DR , DEPT PATHOLOGY
BELLEVILLE, IL
62226-5360

Practice Phone: 618-233-7750
Practice Fax: 314-747-1710

1689651184 — PREMIER INTERNAL MEDICINE LLC
Practice Location Address:

4500 MEMORIAL DR
BELLEVILLE, IL
62226-5360

Practice Phone: 618-476-9399
Practice Fax: 618-476-9547

1245202068 — DR. AMIRA MARY BAHU MD
Practice Location Address:

4500 MEMORIAL DR , DEPT RADIOLOGY
BELLEVILLE, IL
62226-5360

Practice Phone: 618-257-5613
Practice Fax: 314-454-4641

1861440661 — DR. GUILLERMO RODRIGUEZ JR. MD
Practice Location Address:

4500 MEMORIAL DR , DIV MEDICAL ONCOLOGY
BELLEVILLE, IL
62226-5360

Practice Phone: 800-647-2098
Practice Fax: 314-362-3192

1780638932 — BRIAN L MCELANEY MD
Practice Location Address:

4500 MEMORIAL DR , DEPT RADIOLOGY
BELLEVILLE, IL
62226-5360

Practice Phone: 618-257-9567
Practice Fax:

Directions to “ KENNETH I BLUESTONE M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.