Individual
ALAN J BLOMQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1015 OCONOR AVE, LA SALLE, IL 61301-1216
(815) 223-0303
(815) 223-5815
Mailing address
1015 O CONOR AVE, BLDG M, LASALLE, IL 61301
(217) 222-9487
(217) 222-8578
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149005073
IL
Other
Enumeration date
01/02/2007
Last updated
08/23/2010
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