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Individual

JEFFREY BLANK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
31 W DUNDEE RD, WHEELING, IL 60090-4863
(847) 215-1525
(312) 642-9311
Mailing address
31 W DUNDEE RD, WHEELING, IL 60090-4863
(847) 215-1525
(312) 642-9311

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016004427
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
PO 2074
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200820
MEDICARE B
IL
01
480015544
RAILROAD MEDICARE
IL
Enumeration date
08/15/2006
Last updated
03/21/2025
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