Individual
DR. BRADFORD BLAKEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2650 WARRENVILLE RD STE 280, DOWNERS GROVE, IL 60515-2075
(630) 324-7900
Mailing address
2650 WARRENVILLE RD, STE 280, DOWNERS GROVE, IL 60515
(630) 324-7915
(630) 271-1813
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036060663
IL
208600000X
Surgery Physician
1048021
IN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
036060663
IL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
1048021
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
344390
DUPAGE GROUP
—
05
—
36060663
—
IL
01
—
L92675
URBANA
IL
01
—
S26620
COOK GROUP
—
Enumeration date
04/06/2006
Last updated
12/19/2022
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