Basic Information
| Provider Information | |||||||||
| NPI: | 1720419294 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BLUM | ||||||||
| FirstName: | KAREN | ||||||||
| MiddleName: | M. | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | APN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 680 N. LAKE SHORE DRIVE, SUITE 1000 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606113092 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3126950665 | ||||||||
| FaxNumber: | 3126950050 | ||||||||
| Practice Location | |||||||||
| Address1: | 675 NORTH SAINT CLAIR STREET | ||||||||
| Address2: | 17TH FLOOR | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3126959797 | ||||||||
| FaxNumber: | 3126950050 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/09/2013 | ||||||||
| LastUpdateDate: | 02/26/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SM0705X | 209.001976 | IL | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Medical-Surgical |
No ID Information.