Individual
MR. JAMES J. BLATZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C.
Contact information
Practice address
1900 E MAIN ST, DANVILLE, IL 61832
(217) 554-3000
Mailing address
1900 E MAIN ST, DANVILLE, IL 61832-5100
(217) 554-3000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085000740
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
434110
MEDICARE GROUP
IL
01
—
970010117
RAILROAD MEDICARE
IL
Enumeration date
08/01/2006
Last updated
06/20/2019
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