Blueze LLC
NPI #1306371299 in Bloomington, Illinois
Provider Information
- NPI Number
- 1306371299
- Entity Type
- Organization
- Organization Name
- Blueze LLC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Apr 27, 2017
- Last Updated
- Apr 27, 2017
Practice Location
- Address
- 2412 E WASHINGTON ST
- Address 2
- SUITE 6
- City
- Bloomington
- State
- Illinois
- ZIP Code
- 61704-4497
- Phone
- (309) 585-2116
Authorized Official
- Name
- DR. JOEL NILLES, DO
- Title
- SOLE MBR
- Phone
- (309) 585-2116
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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