| Team Blevins Enterprises | |
|
246 E Janata Blvd Ste 210 Lombard IL 60148-5378 | |
| (630) 536-9077 | |
| Not Available |
| Full Name | Team Blevins Enterprises |
|---|---|
| Speciality | Clinic/center |
| Location | 246 E Janata Blvd Ste 210, Lombard, Illinois |
| Authorized Official Name and Position | Lewis Donald Blevins (OWNER) |
| Authorized Official Contact | 6305369077 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Team Blevins Enterprises 309 Kristen St Plano IL 60545-1378 Ph: (630) 536-9077 | Team Blevins Enterprises 246 E Janata Blvd Ste 210 Lombard IL 60148-5378 Ph: (630) 536-9077 |
| NPI Number | 1194515759 |
|---|---|
| Provider Enumeration Date | 05/07/2025 |
| Last Update Date | 05/07/2025 |
| Certification Date | 05/07/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194515759 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
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