EBONEE MONIQUE BLAKE

MAYWOOD, IL
NPI1083356745
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: IL  209025731)
Additional Taxonomies163W00000X Registered Nurse
(Licence: IL  041422578)
Enumeration Date2022-04-12
Last Update Date2023-09-08
Business Address
EBONEE MONIQUE BLAKE
2160 S 1ST AVE
MAYWOOD, IL 60153-3328
Phone number: 708-216-9000
Mailing Address
EBONEE MONIQUE BLAKE
443 N LAVERNE AVE
HILLSIDE, IL 60162-1223
Phone number: 708-769-2519