Individual
STEVEN L. BLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9600 GROSS POINT RD, SKOKIE, IL 60076-1214
(847) 677-9600
Mailing address
2650 RIDGE AVE RM 1223, EVANSTON, IL 60201-1700
(847) 570-2040
(847) 733-5315
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036-085915
IL
208VP0000X
Pain Medicine Physician
036-085915
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-085915
—
IL
01
—
050025825
MEDICARE RAILROAD
IL
01
—
100367930
INDIANA MEDICAID
IL
01
—
363117700
OTHER INS PROVIDER NUMBER
IL
01
—
363117700006
TRICARE
IL
01
—
603710503
US DEPARTMENT OF LABOR
IL
01
—
N276157
WELLCARE CLAIMS
IL
Enumeration date
07/06/2006
Last updated
03/28/2018
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