Individual
DR. BLAKE WILLIAM RANDLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
20733 N BROAD ST, CARLINVILLE, IL 62626-3710
(217) 854-3141
Mailing address
1210 WASHINGTON ST, HIGHLAND, IL 62249-1925
(186) 544-5206
(618) 654-1063
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
209031892
IL
Other
Enumeration date
07/19/2010
Last updated
04/07/2025
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