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NPI Code Detail

MEDICARE: ALLISON RACHEL BLAIR PA-C

MEDICARE: ALLISON RACHEL BLAIR PA-C
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
1363AM0700XMedical Physician Assistant085-003120IL
2363AS0400XSurgical Physician Assistant085-003120IL

General Provider Information

NPI Number : 1497932818
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON RACHEL BLAIR PA-C
Provider Business Mailing Address
First Line : PO BOX 74008272
Second Line :
City : CHICAGO
State : IL
Zip : 60674-8272
Country : US
Telephone Number : 702-899-0595
Fax Number : 702-977-1496
Provider Business Practice Location Address
First Line : 401 N MICHIGAN AVE STE 1200
Second Line :
City : CHICAGO
State : IL
Zip : 60611-4264
Country : US
Telephone Number : 872-231-3074
Fax Number : 312-635-0050
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2008
Last Update Date : 10/03/2025

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