Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jose Balboa Blanco, SURGICALASSISTANT

Individual provider Surgical Assistant · NPI 1902252125

Jose Balboa Blanco, SURGICALASSISTANT is a Surgical Assistant in Mokena, Illinois. Practices as a sole proprietor. Licensed in Colorado and Illinois.

Licensed in
CO, IL
In the registry since
2016
Specialties on file
2
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Practice location Address checks out

18761 Chestnut Ct
Mokena, IL 60448-9501
Phone: (786) 296-5425
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 238.000547 (IL)
Surgical Assistant Taxonomy 246ZC0007X · Licence 15-483 (CO)

Record details

NPI number1902252125
Entity typeIndividual (Type 1)
GenderMale
Credentials SURGICALASSISTANT
Sole proprietorYes
NPI enumeratedMay 6, 2016
Last updated in NPPESJune 7, 2025
Certification dateJune 7, 2025

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