IndividualActive
Dale Blaise, MD
NPI 1770557472 · Family Medicine Physician · Murphysboro, IL
Provider details
- NPI number
- 1770557472
- Entity type
- Individual
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 036065426 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
19 E Shawnee Dr Ste 2
Murphysboro, IL 62966-7072
Phone: (618) 684-2172
Fax: (618) 687-4480
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 3988
Carbondale, IL 62902-3988
Registry dates
- Enumerated
- 2006-02-17
- Last updated
- 2022-08-24
- Certified
- 2022-08-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.