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General NPI Number Information
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NPI Number | 1881798007
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Entity Type | Organization
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Legal Business Name | BLYUMIN FOOT & ANKLE CLINIC LTD
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Dates
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Enumeration Date | 09/08/2006
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Last Update Date | 08/27/2008
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Provider Practice Location Address
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Address Line | 1405 W. MORSE AVE.
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City | CHICAGO
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State | IL
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Zip | 60626
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Country | US
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Telephone | 773-743-5100
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Fax | 773-743-0932
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Provider Business Mailing Address
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Address Line | 1405 W. MORSE AVE.
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City | CHICAGO
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State | IL
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Zip | 60626
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Country | US
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Telephone | 773-743-5100
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Fax | 773-743-0932
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Authorized Official
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Title or Position | DR./OWNER
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Name | LEONID BLYUMIN
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Credential | D.P.M.
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Telephone | 773-743-5100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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