Dr. Bruce A Blacker, M.D.
Internal Medicine in Chicago, IL. Individual provider (NPI-1).
NPI number1982603924
StatusActive
Last updated in NPPESOct 5, 2011
Details
- NPI
- 1982603924
- Entity type
- Individual (NPI-1)
- Name
- Dr. Bruce A Blacker
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 20, 2005
- Last updated
- Oct 5, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 036072584 | IL | Yes |
Practice location
2800 N Sheridan RdSuite 400
Chicago, IL 60657-6157
Phone 773-472-5803 · Fax 773-472-7902
Mailing address
2800 N Sheridan RdSuite 400
Chicago, IL 60657-6157
Phone 773-472-5803
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