MEDICARE: PIERRE RENAUD BLEMUR JR. M.D.

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	207RN0300X	Nephrology Physician	MD.202476	LA
2	207RN0300X	Nephrology Physician	036115764	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457556417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PIERRE RENAUD BLEMUR JR. M.D.

Provider Business Mailing Address
First Line	:	710 N FAIRBANKS CT STE 4-500
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-3013
Country	:	US
Telephone Number	:	312-926-4880
Fax Number	:	312-926-4885

Provider Business Practice Location Address
First Line	:	710 N FAIRBANKS CT STE 4-500
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-3013
Country	:	US
Telephone Number	:	312-926-4880
Fax Number	:	312-926-4885

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

Provider Enumeration Date	:	06/19/2007
Last Update Date	:	05/03/2022

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