Provider Demographics
NPI:1457556417
Name:BLEMUR, PIERRE RENAUD JR (MD)
Entity Type:Individual
Prefix:
First Name:PIERRE
Middle Name:RENAUD
Last Name:BLEMUR
Suffix:JR
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 1:710 N FAIRBANKS CT STE 4-500
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3013
Mailing Address - Country:US
Mailing Address - Phone:312-926-4880
Mailing Address - Fax:312-926-4885
Practice Address - Street 1:710 N FAIRBANKS CT STE 4-500
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3013
Practice Address - Country:US
Practice Address - Phone:312-926-4880
Practice Address - Fax:312-926-4885
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.202476207RN0300X
IL036115764207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1342378Medicaid
MS03877098Medicaid
LA4N512Medicare PIN
MS03877098Medicaid