Individual
DR. DAVID BRIAN YABLONSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1181 STATE RT 157 SUITE 200, EDWARDSVILLE, IL 62025
(618) 288-8850
(618) 288-8943
Mailing address
6810 STATE RT 162 BOX 215, MARYVILLE, IL 62062-8501
(618) 391-6405
(618) 288-4088
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036115282
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0236034
—
IA
01
—
207465
MEDICARE PTAN
IL
01
—
P01132211
RR MEDICARE
IL
Enumeration date
11/07/2005
Last updated
03/10/2020
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