Roberta E Blandon
Obstetrician & Gynecologist Gynecologist Female Pelvic Medicine and Reconstructive Surgeon
1875 Dempster St Ste 665
Park Ridge
, Illinois 60068
Roberta E Blandon
Obstetrician & Gynecologist Gynecologist Female Pelvic Medicine and Reconstructive Surgeon
1875 Dempster St Ste 665
Park Ridge
, Illinois 60068
(847) 825-1604
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About
Features
Specialties
- Obstetrician & Gynecologist
- Female Pelvic Medicine and Reconstructive Surgeon
- Gynecologist
Languages spoken
- English
Location
First Address
- Roberta E Blandon
- 1875 Dempster St Ste 665
- Park Ridge, IL
- Zip : 60068-1168
- Fax : (847) 825-1604
- Phone : (847) 825-1590
Second Address
- Roberta E Blandon
- 1875 Dempster St Ste 665
- Park Ridge, IL
- Zip : 60068
- Fax : (847) 825-1604
- Phone : (847) 825-1590
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207V00000X | Obstetrician & Gynecologist | 2001015985 | MO |
| Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 036147113 | IL |
| N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 2001015985 | MO |
| N | 207VG0400X | Gynecologist | 036147113 | IL |
National Provider Identifier
| NPI | 1669450011 |
|---|---|
| Provider Name | Roberta E Blandon |
| First Address | Park Ridge, IL 60068-1168 |
| Second Address | Park Ridge, IL 60068 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/01/2006 |
| Last Update Date | 09/08/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036147113 | (05) | IL |
| 2001015985 | (05) | MO |
| I33259 | (02) | |
| L6224 | (05) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.