Individual
MATTHEW J. BLECHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
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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