Individual
DR. BLAINE HARBOURNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ND
Contact information
Practice address
486 S SPRING RD, ELMHURST, IL 60126-3858
(586) 246-1480
Mailing address
1230 SAINT JAMES PL APT 1A, GLEN ELLYN, IL 60137-7804
(586) 246-1480
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164007341
IL
Other
Enumeration date
08/15/2018
Last updated
08/15/2018
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