DR. GRACE BLITZER MD NPI 1053844852

NPI Information

NPI: 1053844852
Provider Name: DR. GRACE BLITZER, MD
Classification: Radiology - 2085R0001X
Entity Type: Individual

Specialization: Radiation Oncology

Organization: ROCKFORD HEALTH PHYSICIANS

PECOS Registration: Yes

Address:
2400 N ROCKTON AVE
ROCKFORD, IL
ZIP 61103
Phone: (815) 971-6188
Get Directions

DR. Grace Blitzer, MD is a radiation oncology radiology in Rockford, IL with 7 years of experience. The provider is a radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. DR. Grace Blitzer, MD NPI is 1053844852. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: MEDICAL COLLEGE OF WISCONSIN
Graduation Year:2017

The provider's business location address is:

2400 N ROCKTON AVE
ROCKFORD, IL
ZIP 61103-655
Phone: (815) 971-6188
Fax: (815) 968-9677

The NPI 1053844852 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/7/2017 and was last updated on 9/11/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0001X	Radiology	Radiation Oncology	71953-20	WISCONSIN	No
2	390200000X	Student in an Organized Health Care Education/Training Program				No
3	2085R0001X	Radiology	Radiation Oncology	036153596	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1053844852	MEDICAID	WISCONSIN
2	036153596	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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