Healthcare Provider Details

I. General information

NPI: 1982232187
Provider Name (Legal Business Name): PAIGE ALEXANDRA BLINN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 04/01/2020
Certification Date: 04/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF ILLINOIS HOSPITAL, 1740 W. TAYLOR ST.
CHICAGO IL
60612
US

IV. Provider business mailing address

UIC SURGICAL RESIDENCY RM 367 (MC 958), 820 S. WOOD ST.
CHICAGO IL
60612
US

V. Phone/Fax

Practice location:
  • Phone: 866-600-2273
  • Fax:
Mailing address:
  • Phone: 312-996-6765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: