Individual
DR. RICHARD BLANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1802 S MATTIS AVE, CHAMPAIGN, IL 61821-5923
(217) 383-1850
(217) 383-3439
Mailing address
611 W PARK ST, FAPC, URBANA, IL 61801
(217) 902-5292
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
Primary
223476
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1669521480
SANDHILLS
NC
05
—
1669521480
—
NC
01
—
185TN
BCBS
NC
01
—
277884
MEDCOST
NC
01
—
3021917
UNITED HEALTHCARE
NC
01
—
9323083
AETNA
NC
01
—
Q0024X
SC MEDICAID
SC
Enumeration date
01/10/2007
Last updated
01/20/2021
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