Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. BLAKE WILLIAM RANDLES, D.C.
Active Sole ProprietorDR. BLAKE WILLIAM RANDLES, D.C. is a Gerontological Nurse Practitioner healthcare provider located in CARLINVILLE, Illinois. NPI 1679886675 is currently active in the NPPES registry. Verify at CMS.
Gerontological Nurse Practitioner · CARLINVILLE, IL
Registration Details
- NPI Number
- 1679886675
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 19, 2010 (16.108117781023 yrs)
- Last Updated
- Apr 7, 2025
- License
-
209031892 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
20733 N BROAD STCARLINVILLE, IL, 626263710Browse IL providers · Browse ZIP 62626
- Phone
- 2178543141
- Primary Specialty
-
Gerontological Nurse Practitioner
363LG0600X
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.