person
Thomas Blackwell JR., MD
Student in an Organized Health Care Education/Training Program in Peoria, Illinois
NPI 1003666421

Thomas Blackwell JR. is a Student in an Organized Health Care Education/Training Program based in Peoria, IL. Thomas Blackwell JR. practices in Peoria, IL and has the professional credentials of MD. The NPI Number for Thomas Blackwell JR. is 1003666421 and holds a License No. (Illinois).

The current practice location address for Thomas Blackwell JR. is 530 Ne Glen Oak Ave, Peoria, IL and can be reached out via phone at 309-655-2000.

Location: 530 Ne Glen Oak Ave, Peoria, IL, 61637-0001
person
Provider Profile Details
NPI Number
1003666421
Provider Name
Thomas Blackwell JR.
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
530 Ne Glen Oak Ave, Peoria, IL, 61637-0001
Phone Number
309-655-2000
Fax Number
Provider Enumeration Date
03/26/2024
Last Update Date
04/14/2024
institution
Provider Business Practice Location Address Details
Address
530 Ne Glen Oak Ave
City
State
Zip
61637-0001
Phone Number
309-655-2000
Fax Number
person
Provider Business Mailing Address Details
Address
530 Ne Glen Oak Ave
City
State
Zip
61637-0001
Phone Number
309-655-2000
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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