Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 036113929 | IL |
Y | 207RC0000X | Internist - Cardiovascular Disease | 11772A | WY |
N | 207RI0011X | Interventional Cardiology | 036113929 | IL |
NPI | 1023042744 |
---|---|
Provider Name | Dr. John Edward Abellera Blair |
First Address | Chicago, IL 60637-1447 |
Second Address | Chicago, IL 60637-1447 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 02/04/2021 |