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General NPI Number Information
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NPI Number | 1265548333
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Entity Type | Individual
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Provider Name | STEVEN PAUL BLOCH MD
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Gender | Male
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1160 PARK AVE WEST SUITE 2 EAST
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City | HIGHLAND PARK
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State | IL
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Zip | 60035
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Country | US
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Telephone | 847-432-0840
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Fax | 847-432-0891
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Provider Business Mailing Address
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Address Line | 1160 PARK AVE WEST SUITE 2 EAST
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City | HIGHLAND PARK
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State | IL
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Zip | 60035
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Country | US
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Telephone | 847-432-0840
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Fax | 847-432-0891
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 36550841
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License Number State | IL
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