Lloyd J Blakeman III Dosc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-090891 Issued in IL

Legal business name

LLOYD J BLAKEMAN III DOSC

Practice address

7110 W 127TH St
Ste 250
Palos Heights, IL 60463-1571

Phone

(708) 448-2077

Fax

(708) 671-8892

NPI assigned

Mar 5, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Lloyd J Blakeman III, D.O.

Title

President

Phone

(708) 597-0032

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457395200000",
    "number": "1831369909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7110 W 127TH ST",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631571",
            "telephone_number": "708-448-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7110 W 127TH ST",
            "address_2": "STE 250",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631571",
            "telephone_number": "708-448-2077",
            "fax_number": "708-671-8892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LLOYD J BLAKEMAN III DOSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-05",
        "last_updated": "2016-03-08",
        "status": "A",
        "authorized_official_last_name": "BLAKEMAN",
        "authorized_official_first_name": "LLOYD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-597-0032",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-090891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PTAN",
            "identifier": "IL5796001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "IL5796",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Palos Heights, IL
• Providers in Palos Heights, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.