Individual
DR. JOSHUA A BLOMGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
25 N WINFIELD ROAD, WINFIELD, IL 60190-1295
(630) 682-5653
Mailing address
1 WESTBROOK CORPORATE CTR, SUITE 240, WESTCHESTER, IL 60154-5701
(708) 236-2673
(708) 492-5673
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036-122632
IL
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
036-122632
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036122632 1
—
IL
01
—
1633878
BCBS
IL
01
—
9084591
AETNA
IL
01
—
P01010062
RR MEDICARE
IL
Enumeration date
07/30/2008
Last updated
03/01/2023
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