Mark Blitstein, M.D.
Individual provider Active NPI Specialist · Lake Forest, IL
NPI 1922086560 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1922086560
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- Practice address
- 800 N Westmoreland Rd
Suite 102
Lake Forest, IL 60045-1673 - Phone
- (847) 295-1300
- Fax
- (847) 295-1574
- NPI assigned
- Jan 4, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036054922 | IL | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Forest Endoscopy Center LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | IL | Yes |
Addresses
Primary practice location
800 N Westmoreland Rd
Suite 102
Lake Forest, IL 60045-1673
Mailing address
800 N Westmoreland Rd
Suite 102
Lake Forest, IL 60045-1673
Phone (847) 295-1300
Other providers in Lake Forest, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.