Ackman Blake, Kathleen

Ackman Blake, Kathleen is an individual health care provider with primary practice located at 126 W First Street , Hinsdale IL 60521. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Ackman Blake, Kathleen can be contacted via phone (630) 325-5200.

Contact Information

Primary practice address
126 W First Street Hinsdale IL 60521
Phone: (630) 325-5200
Fax: (630) 325-5569
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 0360647112 Illinois

Profile Details

NPI number 1497734966
LBN Legal business name Ackman Blake, Kathleen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 12th, 2006
Last updated Jul 21st, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497734966 NPPES
Illinois Other L77523 MEDICARE PTAN
Illinois MEDICAID 0360647112 MEDICARE PTAN

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