Blake Medical Care Sc
Family Medicine in Libertyville, IL. Organization (NPI-2).
NPI number1013663749
StatusActive
Last updated in NPPESFeb 22, 2022
Details
- NPI
- 1013663749
- Entity type
- Organization (NPI-2)
- Legal business name
- Blake Medical Care Sc
- Organization subpart
- No
- Enumeration date
- Feb 22, 2022
- Certification date
- Feb 22, 2022
- Last updated
- Feb 22, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Other names
- The Good Doc Direct Primary Care (Doing Business As)
Practice location
131 E Park Ave Ste 103Libertyville, IL 60048-2858
Phone 847-984-3290
Mailing address
1350 Country CtLibertyville, IL 60048-1029
Phone 847-984-3290
Authorized official
Katherine Blake
President
8479843290
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All 47 Family Medicine Physician providers in Libertyville · All 1,805 providers in Libertyville
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