KATHERINE M BLAKE

LIBERTYVILLE, IL
NPI1225304322
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: IL  036136377)
Additional Taxonomies207Q00000X Family Medicine
(Licence: IL  125-061735)
207Q00000X Family Medicine
(Licence: WI  64086)
207QB0002X Family Medicine, Bariatric Medicine
(Licence: IL  036136377)
Enumeration Date2012-03-22
Last Update Date2022-05-03
Business Address
Dr. KATHERINE M BLAKE D.O.
131 E PARK AVE STE 103
LIBERTYVILLE, IL 60048-2858
Phone number: 847-984-3290
Mailing Address
Dr. KATHERINE M BLAKE D.O.
131 E PARK AVE STE 103
LIBERTYVILLE, IL 60048-2858
Phone number: 847-984-3290