Blethen, Liesl Marie

Blethen, Liesl Marie is an individual health care provider with primary practice located at 1051 W Rand Rd # 110 , Arlington Heights IL 60004-2315. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Blethen, Liesl Marie can be contacted via phone (847) 618-9292.

Contact Information

Primary practice address
1051 W Rand Rd # 110 Arlington Heights IL 60004-2315
Phone: (847) 618-9292
Fax: (847) 618-9294
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085.006257 Illinois

Profile Details

NPI number 1730600271
LBN Legal business name Blethen, Liesl Marie
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 6th, 2017
Last updated Oct 12th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730600271 NPPES
Illinois Other 085006257 STATE LICENSE

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