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General NPI Number Information
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NPI Number | 1861827040
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Entity Type | Individual
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Provider Name | WAYNE BLUME R.N.
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Gender | Male
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Dates
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Enumeration Date | 09/06/2013
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Last Update Date | 09/06/2013
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Provider Practice Location Address
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Address Line | 2111 OGDEN AVE
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City | AURORA
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State | IL
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Zip | 60504-7597
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Country | US
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Telephone | 630-978-3800
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Fax |
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Provider Business Mailing Address
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Address Line | 497 WAUBONSEE CIR
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City | OSWEGO
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State | IL
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Zip | 60543-8728
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Country | US
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Telephone | 630-703-9999
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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 | 163WX0800X
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Taxonomy Name | Orthopedic Registered Nurse
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License Number | 041.217474
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License Number State | IL
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