BLAKE A BULLOCK

EVANSTON, IL
NPI1295505014
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: IL  149.024395)
Enumeration Date2024-01-03
Last Update Date2025-07-02
Business Address
BLAKE A BULLOCK LCSW
708 CHURCH ST STE 223
EVANSTON, IL 60201-3881
Phone number: 312-620-0396
Mailing Address
BLAKE A BULLOCK LCSW
1649 W PRATT BLVD APT 3B
CHICAGO, IL 60626-4127
Phone number: 309-540-8401
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