Individual
AMY L BLAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
801 S MILWAUKEE AVE, LIBERTYVILLE, IL 60048-3204
(847) 990-5450
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036107576
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036107576
—
IL
Enumeration date
10/20/2005
Last updated
06/06/2022
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