Dr. Dean Thomas Blazek, D.C.
Chiropractor in Brookfield, WI. Individual provider (NPI-1).
NPI number1720139413
StatusActive
Last updated in NPPESNov 11, 2022
Details
- NPI
- 1720139413
- Entity type
- Individual (NPI-1)
- Name
- Dr. Dean Thomas Blazek
- Credential
- D.C.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 16, 2007
- Certification date
- Nov 11, 2022
- Last updated
- Nov 11, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - CHIROPRACTIC
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | 3675-012 | WI | Yes |
Practice location
19395 W Capitol Dr Ste L05Brookfield, WI 53045-2741
Phone 262-424-4882
Mailing address
W193 Oosty AveOconomowoc, WI 53066-5532
Phone 262-424-4882
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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