# BLAKE H. HORIO, M.D., LTD

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** BLAKE H. HORIO, M.D, LTD
- **Other names:** Blake H. Horio, M.D.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1114115037
- **Legal business name:** BLAKE H. HORIO, M.D, LTD
- **Authorized official:** DR. BLAKE H HORIO M.D. (OWNER/PHYSICIAN)
- **Authorized official phone:** (630) 734-2000

## Contact information

- **Practice address:** 710 N YORK RD, HINSDALE, IL 60521-3555
- **Practice address phone:** (630) 734-2000
- **Practice address fax:** (630) 734-1090
- **Mailing address:** PO BOX 643, HINSDALE, IL 60522-0643
- **Mailing address phone:** (630) 734-2000
- **Mailing address fax:** (630) 734-1090

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 036-090898 | IL | Yes |

## Other

- **Enumeration date:** 10/04/2007
- **Last updated:** 07/11/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0001630006 | BLUE CROSS BLUE SHIELD | IL |
| 05 | — | 036090898 | — | IL |
| 01 | — | 180028812 | RAILROAD MEDICARE | IL |