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General NPI Number Information
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NPI Number | 1497890313
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Entity Type | Organization
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Legal Business Name | THOMAS E. BLANEY, DPM, P.C.
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1501 OGDEN AVE
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-2742
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Country | US
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Telephone | 630-963-3668
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Fax | 630-963-4557
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Provider Business Mailing Address
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Address Line | 1501 OGDEN AVE
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-2742
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Country | US
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Telephone | 630-963-3668
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Fax | 630-963-4557
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Authorized Official
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Title or Position | PRESIDENT
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Name | THOMAS EDWARD BLANEY
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Credential | DPM
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Telephone | 630-963-3668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State | IL
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