KATRINA LAKE

OLYMPIA FIELDS, IL
NPI1679866305
Former NameKATRINA BLANCH
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy207V00000X Obstetrics & Gynecology
(Licence: IL  036141229)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2011-05-27
Last Update Date2021-10-25
Business Address
Dr. KATRINA LAKE MD
20201 CRAWFORD AVE
OLYMPIA FIELDS, IL 60461-1010
Phone number: 708-679-2160
Mailing Address
Dr. KATRINA LAKE MD
35318 EAGLE WAY
CHICAGO, IL 60678-1353
Phone number: 317-528-4800