Individual
PETER M BLENDONOHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
909 E PALATINE RD, PALATINE, IL 60074-5551
(847) 776-1400
(847) 776-1424
Mailing address
909 E PALATINE RD, PALATINE, IL 60074-5551
(847) 776-1400
(847) 776-1424
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036073954
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01618781
BC/BS
IL
05
—
036073954
—
IL
01
—
250002867
MEDICARE RAILROAD
IL
Enumeration date
12/14/2005
Last updated
10/13/2020
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