Individual
BRIAN P BLACKWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 S PAULINA ST, 527 ACFAC, CHICAGO, IL 60612-3806
(312) 942-6510
Mailing address
111 E CHESTNUT ST APT 32G, CHICAGO, IL 60611-2018
(225) 247-2557
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
125060193
IL
Other
Enumeration date
06/21/2011
Last updated
06/21/2011
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