BRIAN J BLONIGEN (NPI# 1134330426) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1134330426 |
Entity Type | Individual |
Full Name | BRIAN J BLONIGEN |
Credential | M.D. |
Practice Address |
2614 W Jefferson St Joliet IL 60435-6433 |
Mailing Address |
15 Salt Creek Ln Ste 105 Hinsdale IL 60521-2979 |
Practice Telephone | 8157251355 |
Practice Fax Number | 8157303020 |
Mailing Telephone | 6307349560 |
Mailing Fax Number | 6307349565 |
Enumeration Date | 2007-05-25 |
Last Update Date | 2015-08-26 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
036.129649 | IL | Allopathic & Osteopathic Physicians |
N | 2085R0001X |
Radiology Specialization: Radiation Oncology |
57009754 | OH | Allopathic & Osteopathic Physicians |
Street Address |
2614 W JEFFERSON ST |
City | JOLIET |
State | IL |
Zip Code | 60435-6433 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447245071 | Sarode K Pundaleeka | Internal Medicine | 2614 W Jefferson St, Joliet, IL 60435 | 2005-09-20 |
1386207306 | Wanda Matthews | Nurse Practitioner | 2614 W Jefferson St, Joliet, IL 60435-6433 | 2019-04-16 |
1366903452 | Precision Radiation Oncology LLC | Radiology | 2614 W Jefferson St, Joliet, IL 60435-6433 | 2019-03-29 |
1568943637 | Joliet Oncology-hematology Associates Ltd | Durable Medical Equipment & Medical Supplies | 2614 W Jefferson St, Joliet, IL 60435-6433 | 2018-08-27 |
1861883407 | Wendy Arnold | Dietitian, Registered | 2614 W Jefferson St, Joliet, IL 60435-6433 | 2015-02-17 |
1174875090 | Nancy Gerum | Nurse Practitioner | 2614 W Jefferson St, Joliet, IL 60435-6433 | 2012-10-03 |
1861620403 | Virag Dandekar | Radiology | 2614 W Jefferson St, Joliet, IL 60435-6433 | 2009-06-22 |
1669676805 | A Womans Place Inc | Prosthetic/Orthotic Supplier | 2614 W Jefferson St, Joliet, IL 60435-6433 | 2007-06-12 |
1952498628 | Joliet Oncology Hematology Associates Ltd | Radiology | 2614 W Jefferson St, Joliet, IL 60435-6433 | 2006-10-06 |
1801989249 | Joliet Oncology-hematology Associates Ltd | Pharmacy | 2614 W Jefferson St, Joliet, IL 60435-6433 | 2006-09-30 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851889018 | Chime Ajiere | Nurse Practitioner | 511 Theodore St, Joliet, IL 60435 | 2018-04-24 |
1740791284 | Melanie Presnak | Speech-Language Pathologist | 1207 N Larkin Ave, Joliet, IL 60435 | 2017-10-23 |
1831618883 | Jeriel Marsena Quarles | Licensed Practical Nurse | 1617 W Jefferson Street, Joliet, IL 60435 | 2017-09-11 |
1053769760 | Cody Hutchinson | Physical Therapy Assistant | 2943 W Jefferson St, Joliet, IL 60435 | 2016-06-03 |
1659748549 | Megan Ryab | Massage Therapist | 501 Wilcox St, Joliet, IL 60435 | 2015-08-26 |
1922416197 | Kodo Care, Inc. | Pharmacy | 221 Springfield Avenue, Suite A, Joliet, IL 60435 | 2014-07-31 |
1528489739 | My Family Doc LLC | Family Medicine | 2001-03 Essington Rd, Joliet, IL 60435 | 2013-12-16 |
1184973869 | R A Lombardi Dds PC | Dentist | 3011 Theodore St., Joliet, IL 60435 | 2012-09-10 |
1245546076 | Kelly Rae Lesemann | Chiropractor | 1011 Essington Road, Joliet, IL 60435 | 2010-08-31 |
1932413697 | Ann E Todd | Optometrist | 1521 Essington Road, Everything In Sight, Joliet, IL 60435 | 2010-08-04 |
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Taxonomy Code | 2085R0001X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Radiation Oncology |
A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104807890 | Salwa F Asaad | Radiology | 1301 Copperfield Ave, Suite 116, Joliet, IL 60432-2054 | 2005-11-09 |
1366903452 | Precision Radiation Oncology LLC | Radiology | 2614 W Jefferson St, Joliet, IL 60435-6433 | 2019-03-29 |
1861620403 | Virag Dandekar | Radiology | 2614 W Jefferson St, Joliet, IL 60435-6433 | 2009-06-22 |
1952498628 | Joliet Oncology Hematology Associates Ltd | Radiology | 2614 W Jefferson St, Joliet, IL 60435-6433 | 2006-10-06 |
1588760144 | Vera Petras | Radiology | 1541 Riverboat Center Dr, Joliet, IL 60431-9341 | 2006-09-14 |
1922031418 | Nuclear Oncology, Sc | Radiology | 2614 W Jefferson St, Joliet, IL 60435-6433 | 2006-07-08 |
1952379042 | Paul M Desrosiers | Radiology | 1541 Riverboat Center Dr, Joliet, IL 60431-9341 | 2006-03-14 |
1255312971 | Samia Luka | Radiology | 1301 Copperfield Ave, Suite 116, Joliet, IL 60432-2054 | 2005-11-09 |
1831170539 | Salwa F Asaad | Radiology | 1301 Copperfield Ave, Suite 116, Joliet, IL 60432-2054 | 2005-11-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629690185 | Illinois Radiation Oncology Consultants Pllc | Radiology | 208 Flax Dr Ste 100, Highland, IL 62249-1396 | 2020-05-07 |
1770070609 | Brian Chou | Radiology | 2160 S 1st Ave Rm 2944, Maywood, IL 60153-3328 | 2018-04-17 |
1932606654 | Amishi Bajaj | Radiology | 2011 Midwest Club Pkwy, Oak Brook, IL 60523-2526 | 2018-04-09 |
1629502208 | Nathaniel Camden | Radiology | 500 South Paulina Street, Atrium Building, Ground Floor, Chicago, IL 60612-3833 | 2017-04-20 |
1811436553 | Seung Won Seol | Radiology | 251 E Huron St Ste Lc-178, Chicago, IL 60611 | 2017-02-14 |
1689051328 | Ross Scott Zeitlin | Radiology | 1901 W Harrison St Ste Ll-500, Chicago, IL 60612-3714 | 2015-05-01 |
1730578527 | Jeffrey Gross | Radiology | 6525 N Mozart St, Apt 3, Chicago, IL 60645-4377 | 2015-01-15 |
1508267220 | Vantage Cancer Care - Illinois, S.c. | Radiology | 17750 South Kedzie Avenue, Hazel Crest, IL 60429-2047 | 2014-09-12 |
1952714636 | Aditya Juloori | Radiology | 5841 S Maryland Ave # Mc9006, Chicago, IL 60637-1443 | 2014-06-10 |
1083047146 | Yoon Tae Kim | Radiology | 1025 Sunset Rd, Winnetka, IL 60093-3622 | 2013-08-13 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.