Individual
DR. ROBERT BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3631 FOREST AVE, UNIT D, BROOKFIELD, IL 60513-1763
(217) 621-3232
Mailing address
3631 FOREST AVE, UNIT D, BROOKFIELD, IL 60513-1763
(217) 621-3232
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019018706
IL
Other
Enumeration date
03/01/2007
Last updated
04/10/2014
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