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Individual

LEONID BLYUMIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1405 W MORSE AVE, CHICAGO, IL 60626
(773) 743-5100
(773) 743-0932
Mailing address
1405 W MORSE AVE, CHICAGO, IL 60626
(773) 743-5100
(773) 743-0932

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016004759
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
016004759
IL
Enumeration date
09/08/2006
Last updated
10/03/2013
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