Individual
CHRISTOPHER THOMAS BLANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
535 PARK AVE E, PRINCETON, IL 61356-2537
(815) 875-4531
(815) 876-2118
Mailing address
530 PARK AVE E, MEDICAL STAFF SERVICES, PRINCETON, IL 61356-3903
(815) 876-2293
(815) 872-6006
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036139239
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036139239
—
IL
Enumeration date
06/27/2013
Last updated
10/13/2020
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