Individual
ELIZABETH BLAIR
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1200 W STATE ST, ROCKFORD, IL 61102-2112
(815) 490-1600
Mailing address
2586 S GOLF RD, STOCKTON, IL 61085-9367
(815) 947-2179
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
IL
Other
Enumeration date
11/23/2005
Last updated
07/09/2007
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