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Contact Information

JUDI E BLAKE, PA-C
2100 PFINGSTEN RD STE 3001
GLENVIEW, IL60026-1301
 Phone: 847-657-5815
 Fax: 847-657-3724
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical

363AS0400X 97 Physician Assistant
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for JUDI E BLAKE · (Female)

NPI Number 1548916786
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 02/25/2022
Last updated 08/05/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • IL License # 085009438
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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