Provider Demographics
NPI:1285645549
Name:BLAIR, MICHAEL P (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:P
Last Name:BLAIR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2454 E DEMPSTER ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-5315
Mailing Address - Country:US
Mailing Address - Phone:847-299-0700
Mailing Address - Fax:847-299-0700
Practice Address - Street 1:2454 E DEMPSTER ST
Practice Address - Street 2:SUITE 400
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-5315
Practice Address - Country:US
Practice Address - Phone:847-299-0700
Practice Address - Fax:847-299-0700
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2017-04-06
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Provider Licenses
StateLicense IDTaxonomies
IL036110558207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology