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

Mr. Justin David Blythe Jr.

Individual provider Neuroscience Registered Nurse · NPI 1669293890

Mr. Justin David Blythe Jr. is a Nurse Practitioner in Park Ridge, Illinois. Qualified in 2025, 1 year ago. Practices with Advocate Health and Hospitals Corporation, a 3,079-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
1
Licensed in
IL
In the registry since
2024
Specialties on file
3

Practice location Address checks out

1875 Dempster St Ste 625
Park Ridge, IL 60068-1137
Phone: (847) 723-4088
Fax: (847) 627-8700
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 801 S Milwaukee Ave, Libertyville, IL 60048-3204 — (847) 990-5666

Specialties & licences

Neuroscience Registered Nurse (primary) Taxonomy 163WN0800X · Licence 041548967 (IL)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 209-032573 (IL)
Nurse Practitioner Taxonomy 363L00000X · Licence 209-032573 (IL)

Record details

NPI number1669293890
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedOctober 21, 2024
Last updated in NPPESOctober 21, 2025
Certification dateOctober 21, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Advocate Health And Hospitals Corporation — 3079 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Park Ridge