Provider Demographics
NPI:1235340449
Name:BLIZNIKAS, DARIUS (MD)
Entity Type:Individual
Prefix:
First Name:DARIUS
Middle Name:
Last Name:BLIZNIKAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7110 W 127TH ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1571
Mailing Address - Country:US
Mailing Address - Phone:312-593-0886
Mailing Address - Fax:312-419-0547
Practice Address - Street 1:7110 W 127TH ST
Practice Address - Street 2:SUITE 210
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1571
Practice Address - Country:US
Practice Address - Phone:312-593-0886
Practice Address - Fax:312-419-0547
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-28
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01071829207Y00000X
ND10900207Y00000X
MI4301085256207YS0012X
IL036109618207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YS0012XAllopathic & Osteopathic PhysiciansOtolaryngologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND10108Medicaid
NDN714041Medicare PIN
ND10108Medicaid