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Individual
PATRICK S BLAIR
Active
Individual
PATRICK S BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070006441
IL
2251H1200X
Hand Physical Therapist
971100300
IL
2255A2300X
Athletic Trainer
096-000362
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619908
BCBS IL GROUP NUMBER
IL
01
—
1623066
BCBS PROVIDER NUMBER
IL
01
—
367885100
US DEPT OF LABOR
IL
01
—
650022358
RAILROAD MEDICARE PIN
IL
01
—
CJ4383
RAILROAD MEDICARE GRP
IL
Enumeration date
07/05/2006
Last updated
11/26/2008
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