person
Annessa R Blackmun, DPM
Podiatrist in Chicago, Illinois
NPI 1538321047

Annessa R Blackmun is a Podiatrist based in Saint Louis, IL. Annessa R Blackmun practices in Chicago, IL and has the professional credentials of DPM. The NPI Number for Annessa R Blackmun is 1538321047 and holds a License No. 2010035799 (Illinois).

The current practice location address for Annessa R Blackmun is 4350 N Broadway St, Chicago, IL and can be reached out via phone at 773-770-0140 and via fax at 773-770-0141.

Location: 4350 N Broadway St, Chicago, IL, 63156-3359
person
Provider Profile Details
NPI Number
1538321047
Provider Name
Annessa R Blackmun
Credential
DPM
Provider Entity Type
Individual
Gender
Female
Address
4350 N Broadway St, Chicago, IL, 63156-3359
Phone Number
773-770-0140
Fax Number
773-770-0141
Provider Enumeration Date
06/26/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
P01781390 01 MO RAILROAD MEDICARE
1538321047 05 MO
P01796928 01 IL RAILROAD MEDICARE
institution
Provider Business Practice Location Address Details
Address
4350 N Broadway St
City
State
Zip
60613-1781
Phone Number
773-770-0140
Fax Number
773-770-0141
person
Provider Business Mailing Address Details
Address
4350 N Broadway St
City
State
Zip
60613-1781
Phone Number
773-770-0140
Fax Number
773-770-0141
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
-
Taxonomy
License No.
016.005464 (Illinois)
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
person
Provider's Taxonomy Details 2
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
2010035799 (Missouri)
Definition
Definition to come...
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