Organization
NAB MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NELSON ARTHUR BLANCO MD (PRESIDENT)
(630) 893-8300
Entity
Organization
Contact information
Practice address
400 W LAKE ST, SUITE 111A, ROSELLE, IL 60172
(630) 893-8300
(630) 893-8324
Mailing address
400 W LAKE ST, SUITE 111A, ROSELLE, IL 60172
(630) 893-8300
(630) 893-8324
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
210043
WPS GROUP #
—
Enumeration date
03/03/2006
Last updated
09/11/2025
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