Blake, Tracy R
Blake, Tracy R is an individual health care provider with primary practice located at 15300 West Ave Ste 221 , Orland Park IL 60462-4508. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Blake, Tracy R can be contacted via phone (708) 590-5300.Contact Information
Primary practice address
15300 West Ave Ste 221
Orland Park IL 60462-4508
Phone: (708) 590-5300
Fax: (708) 590-5310
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Dietary & Nutritional Service Providers / Dietitian, Registered | 133V00000X | 164.004441 | Illinois |
Profile Details
NPI number | 1851570436 |
---|---|
LBN Legal business name | Blake, Tracy R |
Credentials | Registered Dietitian (RD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Oct 30th, 2007 |
Last updated | Dec 1st, 2021 - about 4 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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