MEDICARE: LARHONDA BLACKMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246QL0900X	Laboratory Management Specialist/Technologist

General Provider Information

NPI Number	:	1154272896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARHONDA BLACKMAN

Provider Business Mailing Address
First Line	:	3939 S LAKE PARK AVE APT 1502
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60653-2547
Country	:	US
Telephone Number	:	708-446-4092
Fax Number	:	708-446-4092

Provider Business Practice Location Address
First Line	:	3939 S LAKE PARK AVE APT 1502
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60653-2547
Country	:	US
Telephone Number	:	708-446-4092
Fax Number	:	708-446-4092

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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Directions to “ LARHONDA BLACKMAN ” Practice Location

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