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General NPI Number Information
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NPI Number | 1336345479
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Entity Type | Individual
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Provider Name | CAROL LYNN BLENDOWSKI RN, NP-C
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Gender | Female
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Dates
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Enumeration Date | 06/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 833 W CHICAGO AVE 3RD FL
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City | CHICAGO
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State | IL
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Zip | 60622-5449
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Country | US
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Telephone | 312-633-9490
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Fax | 312-733-8952
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Provider Business Mailing Address
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Address Line | 1444 N ORLEANS ST 5 F
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City | CHICAGO
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State | IL
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Zip | 60610-6537
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Country | US
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Telephone | 312-816-6910
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State | IL
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