Individual
MATTHEW J. BLECHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
1789
WI
2086S0129X
Vascular Surgery Physician
Primary
036109990
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001618161
BCBS OF IL
IL
05
—
036109990
—
IL
01
—
790210
MEDICARE GROUP NUMBER
IL
01
—
P00407297
MEDICARE RAILROAD PART B
IL
Enumeration date
07/07/2006
Last updated
10/25/2020
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