Individual
DR. NICOLE ELIZABETH BLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2501
(217) 383-3313
(217) 383-4014
Mailing address
611 W PARK ST, FAPC, URBANA, IL 61801-2500
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036167793
IL
207P00000X
Emergency Medicine Physician
125.078748
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/17/2021
Last updated
09/30/2025
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