DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. JUSTIN DAVID BLYTHE JR.

Active Sole Proprietor

Neuroscience Nurse · PARK RIDGE, IL

Registration Details

NPI Number
1669293890
Provider Type
Individual
Gender
Male
NPI Issued
Oct 21, 2024 (1.5098166641468 yrs)
Last Updated
Oct 21, 2025
Licenses
041548967 (IL)
209-032573 (IL)
209-032573 (IL)
Sole Proprietor
Yes

Practice Information

Address
1875 DEMPSTER ST STE 625
PARK RIDGE, IL, 600681137
Browse IL providers · Browse ZIP 60068
Phone
8477234088
Fax
8476278700
Primary Specialty
Neuroscience Nurse
163WN0800X
Additional Specialty
Family Nurse Practitioner
Additional Specialty
Nurse Practitioner

Other Neuroscience Nurse Providers in PARK RIDGE, IL

Name Credential NPI
MRS. ROYCE SARAH PEPPA CNS 1902193329
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.